Provider Demographics
NPI:1891460580
Name:ROBINSON, MELISSA JANE (CDCAP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CDCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2749
Mailing Address - Country:US
Mailing Address - Phone:740-935-2608
Mailing Address - Fax:
Practice Address - Street 1:1610 28TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2641
Practice Address - Country:US
Practice Address - Phone:740-354-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177848101YA0400X
OHCDCA.177848101YA0400X
OHOTA001082224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)