Provider Demographics
NPI:1104503465
Name:ROBISON, ANNICIA (LPC, NCC, MS)
Entity type:Individual
Prefix:MS
First Name:ANNICIA
Middle Name:
Last Name:ROBISON
Suffix:
Gender:F
Credentials:LPC, NCC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 BROOK LN
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2435
Mailing Address - Country:US
Mailing Address - Phone:404-808-1901
Mailing Address - Fax:
Practice Address - Street 1:3060 BROOK LN
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-2435
Practice Address - Country:US
Practice Address - Phone:404-808-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health