Provider Demographics
NPI:1063628469
Name:ROBINSON DEVELOPMENTAL, INC.
Entity Type:Organization
Organization Name:ROBINSON DEVELOPMENTAL, INC.
Other - Org Name:GREG ROBINSON, MA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY & INDIVIDUAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MAMFC, MARE, LPC
Authorized Official - Phone:803-939-9699
Mailing Address - Street 1:321 SILVER BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-2470
Mailing Address - Country:US
Mailing Address - Phone:803-238-1911
Mailing Address - Fax:803-939-9086
Practice Address - Street 1:2999 SUNSET BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3496
Practice Address - Country:US
Practice Address - Phone:803-939-9699
Practice Address - Fax:803-939-9086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1245285626Medicare UPIN