MEDICARE: KENYATTA ROBINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	129938-01	NY
2	104100000X	Social Worker	129938-01	NY
3	106S00000X	Behavior Technician	129938-01	NY

General Provider Information

NPI Number	:	1457206344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENYATTA ROBINSON

Provider Business Mailing Address
First Line	:	12110 153RD ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-2324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12110 153RD ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-2324
Country	:	US
Telephone Number	:	718-737-4259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ KENYATTA ROBINSON ” Practice Location

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