Provider Demographics
NPI:1013613561
Name:GREEN, ROBIN LINDSEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LINDSEY
Last Name:GREEN
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 1:2620 S PACE EAST DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-1418
Mailing Address - Country:US
Mailing Address - Phone:520-396-0844
Mailing Address - Fax:
Practice Address - Street 1:2620 S PACE EAST DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1418
Practice Address - Country:US
Practice Address - Phone:520-396-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-179341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical