Provider Demographics
NPI:1790918167
Name:ROBINSON COUNSELING RESOURCES
Entity Type:Organization
Organization Name:ROBINSON COUNSELING RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ANNALISE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CRC
Authorized Official - Phone:706-782-9758
Mailing Address - Street 1:865 KINGWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525
Mailing Address - Country:US
Mailing Address - Phone:706-782-9758
Mailing Address - Fax:706-782-9758
Practice Address - Street 1:340 SMITH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4261
Practice Address - Country:US
Practice Address - Phone:706-782-9758
Practice Address - Fax:706-782-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004529251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA775816127AMedicaid
GA1669527511Medicare NSC