Healthcare Provider Details

I. General information

NPI: 1457124976
Provider Name (Legal Business Name): AVERY REECE ROBBINS M.A., LCHMCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CAROLINA ST STE 114
GREENSBORO NC
27401-1090
US

IV. Provider business mailing address

1301 CAROLINA ST STE 114
GREENSBORO NC
27401-1090
US

V. Phone/Fax

Practice location:
  • Phone: 336-542-2060
  • Fax:
Mailing address:
  • Phone: 336-542-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA19391
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA19391
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: