Provider Demographics
NPI:1265013635
Name:ROBINSON, DOMINIQUE SHAREECE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:DOMINIQUE
Middle Name:SHAREECE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 EASTERN PKWY APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4759
Mailing Address - Country:US
Mailing Address - Phone:516-508-3593
Mailing Address - Fax:
Practice Address - Street 1:1540 EASTERN PKWY APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-4759
Practice Address - Country:US
Practice Address - Phone:516-508-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2021-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111274104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker