Provider Demographics
NPI:1689713893
Name:ROBINSON, DEBRA LAVONNE (CSAC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LAVONNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 S CANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-6232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 N 1ST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2833
Practice Address - Country:US
Practice Address - Phone:704-983-2117
Practice Address - Fax:704-983-2636
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1633101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1633OtherCSAC