1437162948 NPI number — DR. SARA SMITH ROBINSON PHD, LISW-CP

Table of content: LUIS DANIEL PEREZ MARIN (NPI 1336634674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437162948 NPI number — DR. SARA SMITH ROBINSON PHD, LISW-CP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
SARA
Provider Middle Name:
SMITH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LISW-CP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBINSON
Provider Other First Name:
SALLY
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD,LISW-CP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1437162948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 555
Provider Second Line Business Mailing Address:
SALLY ROBINSON, PHD, LISW-CP
Provider Business Mailing Address City Name:
CAMDEN
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29021-0555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-427-1182
Provider Business Mailing Address Fax Number:
803-432-4706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1119 LITTLE STREET
Provider Second Line Business Practice Location Address:
SALLY ROBINSON PHD, LISW-CP
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29020-3612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-427-1182
Provider Business Practice Location Address Fax Number:
803-432-4706
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6803 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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