Provider Demographics
NPI:1497450886
Name:ROBINSON, STEPHANIE NICOLE DEHART (LCSW)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:NICOLE DEHART
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:STEPHANEI
Other - Middle Name:NICOLE
Other - Last Name:DEHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3603 TIMBERLINE TRL
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4526
Mailing Address - Country:US
Mailing Address - Phone:540-313-2330
Mailing Address - Fax:
Practice Address - Street 1:1454 MEXICO WAY NE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-6476
Practice Address - Country:US
Practice Address - Phone:434-533-1088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040151291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical