Provider Demographics
NPI:1467591313
Name:ROBINSON, SUSAN ANN (MSW LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSW LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34816 SWAN CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-5517
Mailing Address - Country:US
Mailing Address - Phone:586-612-1764
Mailing Address - Fax:586-466-6961
Practice Address - Street 1:25401 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2240
Practice Address - Country:US
Practice Address - Phone:586-466-6912
Practice Address - Fax:586-466-6961
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010668081041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool