Provider Demographics
NPI:1508877457
Name:ROBINSON, TRACEY C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:C
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TRACEY
Other - Middle Name:C
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:498 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5609
Mailing Address - Country:US
Mailing Address - Phone:646-629-8545
Mailing Address - Fax:
Practice Address - Street 1:1300 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-1233
Practice Address - Country:US
Practice Address - Phone:646-629-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047901-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical