Provider Demographics
NPI:1235534439
Name:CARSON, ROBYN (MSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:CARSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12434 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2474
Mailing Address - Country:US
Mailing Address - Phone:215-806-8771
Mailing Address - Fax:
Practice Address - Street 1:12434 MADISON DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2474
Practice Address - Country:US
Practice Address - Phone:215-806-8771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula