Provider Demographics
NPI:1285156919
Name:ROBINSON, ANITA ELAINE (NYCPS-P-988)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:ELAINE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NYCPS-P-988
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-5117
Mailing Address - Country:US
Mailing Address - Phone:718-230-1379
Mailing Address - Fax:718-638-1628
Practice Address - Street 1:493 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-5117
Practice Address - Country:US
Practice Address - Phone:718-230-1379
Practice Address - Fax:718-638-1628
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X
NY38794101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist