Provider Demographics
NPI:1558773762
Name:AMBROSINI, ROBIN WEST (MA, EDS, LPCA, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:WEST
Last Name:AMBROSINI
Suffix:
Gender:F
Credentials:MA, EDS, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8193
Mailing Address - Country:US
Mailing Address - Phone:704-953-0253
Mailing Address - Fax:704-978-0006
Practice Address - Street 1:542 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4108
Practice Address - Country:US
Practice Address - Phone:704-953-0253
Practice Address - Fax:704-978-0006
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health