Provider Demographics
NPI:1437420874
Name:ROBINSON, GENA LUANN (LCAS, LPC-A)
Entity Type:Individual
Prefix:MRS
First Name:GENA
Middle Name:LUANN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCAS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11324 POINTER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-0015
Mailing Address - Country:US
Mailing Address - Phone:704-564-4149
Mailing Address - Fax:
Practice Address - Street 1:534 SPRATT ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2969
Practice Address - Country:US
Practice Address - Phone:704-432-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1860101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)