Provider Demographics
NPI:1831320944
Name:ROBINSON, SUSAN H (PC, NCC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:H
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23-1/2 SOUTH PARK PLACE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1610
Mailing Address - Country:US
Mailing Address - Phone:740-403-2855
Mailing Address - Fax:
Practice Address - Street 1:23 S PARK PL
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-5584
Practice Address - Country:US
Practice Address - Phone:740-403-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional