Provider Demographics
NPI:1598466732
Name:PISANO, ROBIN R (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:PISANO
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 1:2713 CHADDSFORD CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6652
Mailing Address - Country:US
Mailing Address - Phone:607-437-3643
Mailing Address - Fax:
Practice Address - Street 1:2713 CHADDSFORD CIR APT 101
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6652
Practice Address - Country:US
Practice Address - Phone:607-437-3643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW211841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical