Provider Demographics
NPI:1821474206
Name:HANDY-ROBINSON, JERROD (PSYD)
Entity Type:Individual
Prefix:MR
First Name:JERROD
Middle Name:
Last Name:HANDY-ROBINSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 W WAVELAND AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4386
Mailing Address - Country:US
Mailing Address - Phone:570-947-8514
Mailing Address - Fax:
Practice Address - Street 1:812 W WAVELAND AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-4386
Practice Address - Country:US
Practice Address - Phone:570-947-8514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor