Healthcare Provider Details

I. General information

NPI: 1366228579
Provider Name (Legal Business Name): CHRISTIAN ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7521 MORGAN RD
LIVERPOOL NY
13090-3538
US

IV. Provider business mailing address

115 SOLAR ST APT 402
SYRACUSE NY
13204-5403
US

V. Phone/Fax

Practice location:
  • Phone: 315-677-7330
  • Fax:
Mailing address:
  • Phone: 315-729-5857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: