Provider Demographics
NPI:1578859765
Name:ROBINSON, DAVIDA LOUISE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DAVIDA
Middle Name:LOUISE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 EDNOR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2050
Mailing Address - Country:US
Mailing Address - Phone:443-983-4674
Mailing Address - Fax:
Practice Address - Street 1:3715 EDNOR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2050
Practice Address - Country:US
Practice Address - Phone:443-983-4674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13937101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker