Healthcare Provider Details

I. General information

NPI: 1710881032
Provider Name (Legal Business Name): LEXUS ROBINSON CSC-AD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 N CALVERT ST
BALTIMORE MD
21202-3705
US

IV. Provider business mailing address

817 N CALVERT ST
BALTIMORE MD
21202-3705
US

V. Phone/Fax

Practice location:
  • Phone: 443-290-6424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberSC3257
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: