Healthcare Provider Details

I. General information

NPI: 1639099369
Provider Name (Legal Business Name): JAMES THERON ROBINSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 W FIREWEED LN STE 100
ANCHORAGE AK
99503-2562
US

IV. Provider business mailing address

PO BOX 748465
ATLANTA GA
30374-8465
US

V. Phone/Fax

Practice location:
  • Phone: 907-885-6457
  • Fax: 617-807-0958
Mailing address:
  • Phone: 855-284-7483
  • Fax: 617-807-0958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number217511
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: