Provider Demographics
NPI:1841041126
Name:ROBINSON, KETARA Q (LCSWA)
Entity type:Individual
Prefix:
First Name:KETARA
Middle Name:Q
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 SMITH MILL RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-8987
Mailing Address - Country:US
Mailing Address - Phone:910-740-4444
Mailing Address - Fax:
Practice Address - Street 1:823 ELM ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4172
Practice Address - Country:US
Practice Address - Phone:910-430-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker