Provider Demographics
NPI:1407614571
Name:ROBINSON, LETITIA N (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LETITIA
Middle Name:N
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 1:5181 WEST MOUNTAIN STREET
Mailing Address - Street 2:#226
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-9998
Mailing Address - Country:US
Mailing Address - Phone:912-484-4944
Mailing Address - Fax:
Practice Address - Street 1:5181 WEST MOUNTAIN STREET
Practice Address - Street 2:#226
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-9998
Practice Address - Country:US
Practice Address - Phone:912-484-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0087061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical