Provider Demographics
NPI:1548025455
Name:RUTLEDGE, ROBIN ROSE (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ROSE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 BANKHEAD DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8122
Mailing Address - Country:US
Mailing Address - Phone:919-454-4056
Mailing Address - Fax:
Practice Address - Street 1:4030 WAKE FOREST RD STE 206
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6800
Practice Address - Country:US
Practice Address - Phone:919-713-0260
Practice Address - Fax:919-591-0161
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health