Healthcare Provider Details

I. General information

NPI: 1285874842
Provider Name (Legal Business Name): CHARLENE HEATHER ROBINSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 LIBERTY ST
BATH NY
14810-1124
US

IV. Provider business mailing address

33 DENISON PKWY W
CORNING NY
14830-2613
US

V. Phone/Fax

Practice location:
  • Phone: 607-936-1771
  • Fax: 607-662-5044
Mailing address:
  • Phone: 607-936-1771
  • Fax: 607-662-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number673026
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number083200-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number075713-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: