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General NPI Number Information
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NPI Number | 1134371248
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Entity Type | Individual
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Provider Name | LINDA LOUISE BROWN ROBERSON LPC,CPCS,CAC-II,CCS
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1008 HIGHWAY 54 W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4515
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Country | US
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Telephone | 770-703-0213
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 HIGHWAY 54 W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4515
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Country | US
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Telephone | 770-703-2131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1928
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC
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License Number State | GA
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