Healthcare Provider Details

I. General information

NPI: 1619396645
Provider Name (Legal Business Name): ROBIN FINE LCSW, PLLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 FAIRVIEW RD
CHARLOTTE NC
28210-3363
US

IV. Provider business mailing address

6845 FAIRVIEW RD
CHARLOTTE NC
28210-3363
US

V. Phone/Fax

Practice location:
  • Phone: 704-577-1179
  • Fax: 704-365-9256
Mailing address:
  • Phone: 704-577-1179
  • Fax: 704-365-9256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW22619
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC009031
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: