Provider Demographics
NPI:1932479375
Name:ROBINSON, ADIA FATIMA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ADIA
Middle Name:FATIMA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 KATRINE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-7426
Mailing Address - Country:US
Mailing Address - Phone:704-718-7494
Mailing Address - Fax:704-334-8815
Practice Address - Street 1:5809 KATRINE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-7426
Practice Address - Country:US
Practice Address - Phone:704-718-7494
Practice Address - Fax:704-334-8815
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC007271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health