Provider Demographics
NPI:1023884418
Name:ROBINSON, ANTHONY (MA, MSSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MA, MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-3231
Mailing Address - Country:US
Mailing Address - Phone:234-444-5055
Mailing Address - Fax:234-444-5467
Practice Address - Street 1:805 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3231
Practice Address - Country:US
Practice Address - Phone:234-444-5055
Practice Address - Fax:234-444-5467
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99121687A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker