Provider Demographics
NPI:1649052747
Name:ROBINSON, AUDREY (LMHCA)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:ROBINSON MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6011 NW 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5651
Mailing Address - Country:US
Mailing Address - Phone:954-729-7585
Mailing Address - Fax:
Practice Address - Street 1:6011 NW 69TH AVE
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5651
Practice Address - Country:US
Practice Address - Phone:954-729-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61428872101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health