Provider Demographics
NPI:1568641033
Name:SHACHNER, ROBIN S (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:S
Last Name:SHACHNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CORAL HILLS DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4137
Mailing Address - Country:US
Mailing Address - Phone:195-475-5011
Mailing Address - Fax:954-755-2209
Practice Address - Street 1:3100 CORAL HILLS DR
Practice Address - Street 2:SUITE 207
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4137
Practice Address - Country:US
Practice Address - Phone:195-475-5011
Practice Address - Fax:954-755-2209
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW36771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SW3677OtherMEDICAL LICENSE