Provider Demographics
NPI:1942970314
Name:LAWRENCE, ROBI
Entity Type:Individual
Prefix:
First Name:ROBI
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 CONCORD LAKE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2892
Mailing Address - Country:US
Mailing Address - Phone:980-781-5156
Mailing Address - Fax:980-781-5346
Practice Address - Street 1:2353 CONCORD LAKE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2877
Practice Address - Country:US
Practice Address - Phone:980-781-5156
Practice Address - Fax:980-781-5346
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0191401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical