Provider Demographics
NPI:1730515941
Name:PRIDE, ROBIN DAYS (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:DAYS
Last Name:PRIDE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 RAEFORD RD STE D
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5750
Mailing Address - Country:US
Mailing Address - Phone:910-379-6855
Mailing Address - Fax:910-438-0906
Practice Address - Street 1:2521 RAEFORD RD STE D
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5750
Practice Address - Country:US
Practice Address - Phone:910-379-6855
Practice Address - Fax:910-294-9681
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NC10434101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562086735Medicaid