Provider Demographics
NPI:1548767403
Name:ROBINSON, LEXXUS S
Entity Type:Individual
Prefix:
First Name:LEXXUS
Middle Name:S
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9482 WEDGEWOOD BLVD STE 50
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-0268
Mailing Address - Country:US
Mailing Address - Phone:614-444-2273
Mailing Address - Fax:
Practice Address - Street 1:9482 WEDGEWOOD BLVD STE 50
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-0268
Practice Address - Country:US
Practice Address - Phone:614-444-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
OHS.1802821104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician