Provider Demographics
NPI:1396852430
Name:ROBINSON, JILL DENISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:DENISE
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 1:3212 HOLT ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-4036
Mailing Address - Country:US
Mailing Address - Phone:606-325-2408
Mailing Address - Fax:
Practice Address - Street 1:207 16TH ST STE 301
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7908
Practice Address - Country:US
Practice Address - Phone:606-329-9333
Practice Address - Fax:606-329-0468
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY16631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical