Basic Information
| Provider Information | |||||||||
| NPI: | 1851488738 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEMASI | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | LORRAINE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6900 NW 9TH BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326054201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523336680 | ||||||||
| FaxNumber: | 3523314006 | ||||||||
| Practice Location | |||||||||
| Address1: | 6900 NW 9TH BLVD | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326054201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523336680 | ||||||||
| FaxNumber: | 3523314006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW 6372 | FL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | LICENSE # | 01 | FL | SW 6372 | OTHER |