Provider Demographics
NPI:1366791634
Name:ROBBINS, EMILY A (LCSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:A
Last Name:ROBBINS
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 1:1900 MADEIRA CIR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7198
Mailing Address - Country:US
Mailing Address - Phone:860-462-3407
Mailing Address - Fax:980-207-2571
Practice Address - Street 1:8832 BLAKENEY PROFESSIONAL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6809
Practice Address - Country:US
Practice Address - Phone:860-462-3407
Practice Address - Fax:980-207-2571
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0082791041C0700X
CT0075211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1366791634Medicaid
NC1366791634Medicaid