Provider Demographics
NPI:1861810798
Name:JARDINE, ROBYN RENEA (LPC, LMFT-S, NCC)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:RENEA
Last Name:JARDINE
Suffix:
Gender:F
Credentials:LPC, LMFT-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 ROSS AVE STE 700-111
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2911
Mailing Address - Country:US
Mailing Address - Phone:469-906-6093
Mailing Address - Fax:
Practice Address - Street 1:2001 ROSS AVE STE 700-111
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-2911
Practice Address - Country:US
Practice Address - Phone:469-906-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202238106H00000X
TX71800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist