Healthcare Provider Details

I. General information

NPI: 1417964537
Provider Name (Legal Business Name): MICHELLE MARIE ROBINS MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CHARLESTON BLVD STE B-230
LAS VEGAS NV
89104-6659
US

IV. Provider business mailing address

4547 WINTER PLACE ST
LAS VEGAS NV
89122-5251
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-5078
  • Fax: 702-968-5050
Mailing address:
  • Phone: 702-968-5078
  • Fax: 702-968-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4519-S
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: