Healthcare Provider Details

I. General information

NPI: 1811986342
Provider Name (Legal Business Name): BERNARD HIGGINS ROBINSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 HC / BRIAN D ALLGOOD ARMY COMMUNITY HOSPITAL UNIT 15245
APO AP
96271
US

IV. Provider business mailing address

PSC 333 BOX 7333
APO AP
96251-0074
US

V. Phone/Fax

Practice location:
  • Phone: 315-737-5875
  • Fax:
Mailing address:
  • Phone: 912-376-0247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW3399
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: