Provider Demographics
NPI:1689816324
Name:ROBINSON, ELIZABETH V (MSSW, LCSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:V
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSSW, LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MOULTRIE STREET
Mailing Address - Street 2:MSC 82
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29409
Mailing Address - Country:US
Mailing Address - Phone:843-612-6442
Mailing Address - Fax:843-927-8170
Practice Address - Street 1:516 WILSON AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29409-7710
Practice Address - Country:US
Practice Address - Phone:843-612-6442
Practice Address - Fax:843-927-8170
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12941003-35011041C0700X
CA874931041C0700X
SC130061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1750Medicaid