Provider Demographics
NPI:1528074879
Name:GANS, ROBIN LEE (LCSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:GANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:STEINHER GANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:9123 VICTORY PASS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4027
Mailing Address - Country:US
Mailing Address - Phone:210-269-1130
Mailing Address - Fax:210-403-2722
Practice Address - Street 1:20079 STONE OAK PKWY
Practice Address - Street 2:SUITE 1240
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-6942
Practice Address - Country:US
Practice Address - Phone:210-269-1130
Practice Address - Fax:210-403-2722
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX338981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189056803Medicaid
TX613939Medicare UPIN