Provider Demographics
NPI:1255525291
Name:ROBINSON, SUSAN LYNNE (LICSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 HEDGEROW DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6879
Mailing Address - Country:US
Mailing Address - Phone:802-489-5826
Mailing Address - Fax:802-878-1477
Practice Address - Street 1:1233 SHELBURNE ROAD
Practice Address - Street 2:SUITE 470
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-489-5826
Practice Address - Fax:802-878-1477
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-0001201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health