Provider Demographics
NPI:1144476029
Name:ROBINSON, CAROLYN ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ANN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1511 MYDLAND RD LOT 150
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2137
Mailing Address - Country:US
Mailing Address - Phone:307-752-7713
Mailing Address - Fax:
Practice Address - Street 1:1511 MYDLAND RD LOT 150
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2137
Practice Address - Country:US
Practice Address - Phone:307-752-7713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY0641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical