Provider Demographics
NPI:1356626220
Name:LAZENBY, CATHY ROBINSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:ROBINSON
Last Name:LAZENBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CATHY
Other - Middle Name:ROBINSON
Other - Last Name:LAZENBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:315 PATTON DR.
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150
Mailing Address - Country:US
Mailing Address - Phone:704-297-0527
Mailing Address - Fax:704-476-8303
Practice Address - Street 1:315 PATTON DR.
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150
Practice Address - Country:US
Practice Address - Phone:704-297-0527
Practice Address - Fax:704-476-8303
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC001556104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker