Provider Demographics
NPI:1720210818
Name:ROBINSON, CHAVON MICHELE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CHAVON
Middle Name:MICHELE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 FALLS RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5152
Mailing Address - Country:US
Mailing Address - Phone:917-586-8346
Mailing Address - Fax:
Practice Address - Street 1:311 MCBEE ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-2818
Practice Address - Country:US
Practice Address - Phone:917-586-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-22
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133491041C0700X
NCC007546104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical