Healthcare Provider Details

I. General information

NPI: 1558679050
Provider Name (Legal Business Name): CAROL RENEE COUNTS ROBINSON PHD, PMHNP-BC,ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 09/27/2022
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 WORCESTER RD
FRAMINGHAM MA
01701-5410
US

IV. Provider business mailing address

139 EASTWOOD AVE
SWANNANOA NC
28778-2607
US

V. Phone/Fax

Practice location:
  • Phone: 508-628-6300
  • Fax:
Mailing address:
  • Phone: 828-691-9757
  • Fax: 828-652-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1431
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5004871
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5004871
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: