Provider Demographics
NPI:1316512973
Name:ROBINSON, DENAUVO M (DR)
Entity type:Individual
Prefix:
First Name:DENAUVO
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SMALL DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-7497
Mailing Address - Country:US
Mailing Address - Phone:252-207-1981
Mailing Address - Fax:
Practice Address - Street 1:604 SMALL DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7497
Practice Address - Country:US
Practice Address - Phone:252-207-1981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS4535101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor