Provider Demographics
NPI:1336860287
Name:ROBINSON, MAYRA EDITH (MSW, LCSWA, LCASA)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:EDITH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSW, LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 RAMONA DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-1954
Mailing Address - Country:US
Mailing Address - Phone:910-644-4217
Mailing Address - Fax:
Practice Address - Street 1:951 S MCPHERSON CHURCH RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5184
Practice Address - Country:US
Practice Address - Phone:910-849-3399
Practice Address - Fax:910-900-0913
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-27921101YA0400X
NCP0180341041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty