Healthcare Provider Details

I. General information

NPI: 1578278255
Provider Name (Legal Business Name): DESTINY A ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 MUDDY CREEK RD
CINCINNATI OH
45238-2057
US

IV. Provider business mailing address

3650 MUDDY CREEK RD
CINCINNATI OH
45238-2057
US

V. Phone/Fax

Practice location:
  • Phone: 513-347-0375
  • Fax: 513-347-0376
Mailing address:
  • Phone: 513-347-0375
  • Fax: 513-347-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: