MEDICARE: MS. BEVERLY CAROL ROBINETTE L.C.S.W.

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	1041C0700X	Clinical Social Worker	0904009274	VA

General Provider Information

NPI Number	:	1699131177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BEVERLY CAROL ROBINETTE L.C.S.W.

Provider Business Mailing Address
First Line	:	454 E MAIN ST
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-3408
Country	:	US
Telephone Number	:	276-300-4422
Fax Number	:	833-276-0046

Provider Business Practice Location Address
First Line	:	454 E MAIN ST
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-3408
Country	:	US
Telephone Number	:	276-300-4422
Fax Number	:	833-276-0046

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

Provider Enumeration Date	:	01/13/2016
Last Update Date	:	01/23/2021

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