Healthcare Provider Details

I. General information

NPI: 1336590488
Provider Name (Legal Business Name): ERIC ROBINSON MA, LLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34855 GARFIELD RD APT 204
FRASER MI
48026-1816
US

IV. Provider business mailing address

34855 GARFIELD RD APT 204
FRASER MI
48026-1816
US

V. Phone/Fax

Practice location:
  • Phone: 313-326-3818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberR152234866969
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401223050
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: