Provider Demographics
NPI:1679850978
Name:ROBINSON, MARJORIE ANN CLAUDETTE (LGSW)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE ANN
Middle Name:CLAUDETTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:MARJORIE ANN
Other - Middle Name:CLAUDETTE
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5750A SOUTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3316
Mailing Address - Country:US
Mailing Address - Phone:251-450-5915
Mailing Address - Fax:251-662-7297
Practice Address - Street 1:372 GREENO RD S
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1916
Practice Address - Country:US
Practice Address - Phone:251-928-2871
Practice Address - Fax:251-662-7297
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2912G104100000X
AL3633C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker