Healthcare Provider Details

I. General information

NPI: 1740782135
Provider Name (Legal Business Name): ANGELA L ROBINSON LCPMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 S STATE ST
DOVER DE
19901-5148
US

IV. Provider business mailing address

155 JOSHUA DR
MAGNOLIA DE
19962-2232
US

V. Phone/Fax

Practice location:
  • Phone: 302-257-3135
  • Fax:
Mailing address:
  • Phone: 302-304-2974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0000853
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: