Provider Demographics
NPI:1821052309
Name:ROBINSON, SALLIE BETTE (MSSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:SALLIE
Middle Name:BETTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:BETTE
Other - Middle Name:SLONE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSSW, LCSW
Mailing Address - Street 1:1062 WELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1200
Mailing Address - Country:US
Mailing Address - Phone:859-219-9399
Mailing Address - Fax:859-219-2398
Practice Address - Street 1:1062 WELLINGTON WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1200
Practice Address - Country:US
Practice Address - Phone:859-219-9399
Practice Address - Fax:859-219-2398
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1575101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000334961OtherANTHEM BC/BS
KY82000951Medicaid
KY000000334961OtherANTHEM BC/BS