Provider Demographics
NPI:1194279489
Name:ROBINSON, CAROLYN (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1327
Mailing Address - Country:US
Mailing Address - Phone:860-756-5153
Mailing Address - Fax:860-567-5153
Practice Address - Street 1:80 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1327
Practice Address - Country:US
Practice Address - Phone:860-756-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT145061041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical