Provider Demographics
NPI:1619631066
Name:ROBINSON-AMAYA, SUSAN (LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ROBINSON-AMAYA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:AMAYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:97 ATLANTA ST STE 301
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-2192
Mailing Address - Country:US
Mailing Address - Phone:678-216-7721
Mailing Address - Fax:
Practice Address - Street 1:97 ATLANTA ST STE 301
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-2192
Practice Address - Country:US
Practice Address - Phone:678-216-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health