Provider Demographics
NPI:1467607549
Name:CODRINGTON, ROBYN REEVES (MSW, LCSW, CCS)
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:REEVES
Last Name:CODRINGTON
Suffix:
Gender:F
Credentials:MSW, LCSW, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 AMITY CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4934
Mailing Address - Country:US
Mailing Address - Phone:704-566-3633
Mailing Address - Fax:704-288-4391
Practice Address - Street 1:3139 AMITY CT
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4934
Practice Address - Country:US
Practice Address - Phone:704-566-3633
Practice Address - Fax:704-288-4391
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0062321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007198Medicaid
NC2853448AMedicare PIN