Provider Demographics
NPI:1245285626
Name:ROBINSON, GREGORY HOWARD (MAMFC MARE LPC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:HOWARD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MAMFC MARE LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:321 SILVER BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170
Mailing Address - Country:US
Mailing Address - Phone:803-957-7338
Mailing Address - Fax:803-939-9086
Practice Address - Street 1:2999 SUNSET BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:803-939-9699
Practice Address - Fax:803-939-9086
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5729OtherPALMETTO HEALTH BAPTIST