Provider Demographics
NPI:1275241325
Name:GEORGE, ROBIN ROCHELLE (CSW)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ROCHELLE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WOODLAWN SPGS
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9160
Mailing Address - Country:US
Mailing Address - Phone:502-275-8804
Mailing Address - Fax:
Practice Address - Street 1:282 BRULE ST
Practice Address - Street 2:BLDGE 872
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121
Practice Address - Country:US
Practice Address - Phone:502-287-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical