Basic Information
Provider Information
NPI: 1508011636
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBINSON
FirstName: CHRISTY
MiddleName: STANCILL
NamePrefix: MRS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1704A E ARLINGTON BLVD STE A
Address2:  
City: GREENVILLE
State: NC
PostalCode: 278585872
CountryCode: US
TelephoneNumber: 2527564899
FaxNumber: 2527565141
Practice Location
Address1: 1704A E ARLINGTON BLVD STE A
Address2:  
City: GREENVILLE
State: NC
PostalCode: 278585872
CountryCode: US
TelephoneNumber: 2527564899
FaxNumber: 2527565141
Other Information
ProviderEnumerationDate: 11/17/2008
LastUpdateDate: 01/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XC006233NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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