Provider Demographics
NPI:1700061793
Name:ROBSON, ALICE SPENCER (LISW)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:SPENCER
Last Name:ROBSON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 SHAMROCK AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-8228
Mailing Address - Country:US
Mailing Address - Phone:803-285-5777
Mailing Address - Fax:
Practice Address - Street 1:1742 SHAMROCK AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-8228
Practice Address - Country:US
Practice Address - Phone:803-285-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical