Provider Demographics
NPI:1043711567
Name:ROBINSON, REBECCA (MHS, CADC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MHS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 GIBBS ST FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-1856
Mailing Address - Country:US
Mailing Address - Phone:203-745-6979
Mailing Address - Fax:203-397-9077
Practice Address - Street 1:900 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2802
Practice Address - Country:US
Practice Address - Phone:203-787-2111
Practice Address - Fax:203-397-9077
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health