Basic Information
Provider Information
NPI: 1710255468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRYSON
FirstName: ROBIN
MiddleName: FAITH
NamePrefix: MRS.
NameSuffix: I
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 204 CHARLOTTE HWY STE E
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288038681
CountryCode: US
TelephoneNumber: 8283335708
FaxNumber: 8282131634
Practice Location
Address1: 204 CHARLOTTE HWY STE E
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288038681
CountryCode: US
TelephoneNumber: 8283335708
FaxNumber: 8282131634
Other Information
ProviderEnumerationDate: 12/08/2011
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XP006867NCN Behavioral Health & Social Service ProvidersSocial WorkerClinical
1041C0700XC008573NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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