Provider Demographics
NPI:1255841946
Name:ROBINSON, CHERYL B (CSAC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:B
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-2432
Mailing Address - Country:US
Mailing Address - Phone:919-961-0495
Mailing Address - Fax:
Practice Address - Street 1:2321 CRABTREE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-2263
Practice Address - Country:US
Practice Address - Phone:919-848-9108
Practice Address - Fax:919-848-9109
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-07
Last Update Date:2017-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)