Provider Demographics
NPI:1548549769
Name:ROBINSON, ROBIN (LCSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1289 ROBERTA HWY
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:GA
Mailing Address - Zip Code:31006-3749
Mailing Address - Country:US
Mailing Address - Phone:478-550-5323
Mailing Address - Fax:
Practice Address - Street 1:1289 ROBERTA HWY
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:GA
Practice Address - Zip Code:31006-3749
Practice Address - Country:US
Practice Address - Phone:478-550-5323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical