Provider Demographics
NPI:1255763967
Name:ROBINSON, MAZI MOORE (LPC)
Entity type:Individual
Prefix:MRS
First Name:MAZI
Middle Name:MOORE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 ALLISON DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4503
Mailing Address - Country:US
Mailing Address - Phone:404-906-5620
Mailing Address - Fax:
Practice Address - Street 1:12 PIEDMONT CTR NE STE 419
Practice Address - Street 2:3495 PIEDMONT ROAD
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-4817
Practice Address - Country:US
Practice Address - Phone:404-906-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional