Provider Demographics
NPI:1265636310
Name:ROBINSON, LENORE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LENORE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:BLDG 1-D
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-920-7933
Mailing Address - Fax:732-920-2966
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:BLDG 1-D
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-920-7933
Practice Address - Fax:732-920-2966
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00663800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088397Medicare ID - Type Unspecified