Provider Demographics
NPI:1629898622
Name:LONGNIGHT, ROBIN GUILES (LCSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:GUILES
Last Name:LONGNIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4580
Mailing Address - Country:US
Mailing Address - Phone:541-968-0363
Mailing Address - Fax:
Practice Address - Street 1:950 E 44TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4580
Practice Address - Country:US
Practice Address - Phone:541-968-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical