Provider Demographics
NPI:1073344305
Name:ROBINKOFF, LACEY ANNE (MS)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:ANNE
Last Name:ROBINKOFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 POLARIS LOOP APT 101
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-6809
Mailing Address - Country:US
Mailing Address - Phone:407-227-6797
Mailing Address - Fax:
Practice Address - Street 1:205 HATTERAS AVE STE 105
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6502
Practice Address - Country:US
Practice Address - Phone:352-348-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health