Provider Demographics
NPI:1740327659
Name:ROBINSON, NACOLE R (LPCA)
Entity type:Individual
Prefix:
First Name:NACOLE
Middle Name:R
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:NACOLE
Other - Middle Name:R
Other - Last Name:MALONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:115 ROCKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9415
Mailing Address - Country:US
Mailing Address - Phone:606-436-5761
Mailing Address - Fax:606-435-0817
Practice Address - Street 1:484 TOLLAGE CRK
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3305
Practice Address - Country:US
Practice Address - Phone:606-888-7337
Practice Address - Fax:606-432-1616
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270656101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30610026Medicaid