Provider Demographics
NPI:1912477183
Name:EASTERLING, ROBIN MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARIE
Last Name:EASTERLING
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 1:2106 MACY DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-6340
Mailing Address - Country:US
Mailing Address - Phone:678-288-6221
Mailing Address - Fax:678-288-6221
Practice Address - Street 1:2106 MACY DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-6340
Practice Address - Country:US
Practice Address - Phone:678-288-6221
Practice Address - Fax:678-288-6221
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health