Provider Demographics
NPI:1538683628
Name:ROBINSON, AYEISHA CHEDAA (LAC)
Entity Type:Individual
Prefix:MS
First Name:AYEISHA
Middle Name:CHEDAA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1087
Mailing Address - Country:US
Mailing Address - Phone:908-456-6687
Mailing Address - Fax:
Practice Address - Street 1:482 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-3321
Practice Address - Country:US
Practice Address - Phone:908-456-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00102200101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor