Provider Demographics
NPI:1467135087
Name:LYNN, ROBIN BLAES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:BLAES
Last Name:LYNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:MICHELLE
Other - Last Name:BLAES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:25 ADAMS CIR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8057
Mailing Address - Country:US
Mailing Address - Phone:910-528-2128
Mailing Address - Fax:
Practice Address - Street 1:25 ADAMS CIR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8057
Practice Address - Country:US
Practice Address - Phone:910-528-2128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005032104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker