Provider Demographics
NPI:1790251809
Name:ROBINSON, CHALLIE E (LCSW)
Entity Type:Individual
Prefix:
First Name:CHALLIE
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CLIFTY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-1710
Mailing Address - Country:US
Mailing Address - Phone:606-678-0026
Mailing Address - Fax:
Practice Address - Street 1:600 CLIFTY ST STE 2
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1710
Practice Address - Country:US
Practice Address - Phone:606-678-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2586831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical