Healthcare Provider Details

I. General information

NPI: 1760266720
Provider Name (Legal Business Name): BRIAN K ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 EAST 129TH ST.
CLEVELAND OH
44108-2539
US

IV. Provider business mailing address

959 E 129TH ST
CLEVELAND OH
44108-2539
US

V. Phone/Fax

Practice location:
  • Phone: 216-432-8543
  • Fax:
Mailing address:
  • Phone: 216-432-8543
  • Fax:

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 Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: