Provider Demographics
NPI:1538730783
Name:ROBINSON, MARITZA KENITA (LCSW, LCDC)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:KENITA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16635 SPRING CYPRESS RD UNIT 902
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-1010
Mailing Address - Country:US
Mailing Address - Phone:281-317-7745
Mailing Address - Fax:
Practice Address - Street 1:16726 MAMMOTH SPRINGS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5488
Practice Address - Country:US
Practice Address - Phone:601-382-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX683921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000000000OtherCASH