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General NPI Number Information
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NPI Number | 1891353835
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Entity Type | Individual
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Provider Name | ROBIN CAROL CONRAD LPC, RN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 2600 MEMORIAL AVE STE 104
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City | LYNCHBURG
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State | VA
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Zip | 24501-2658
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Country | US
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Telephone | 434-528-4580
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Fax | 434-528-4584
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Provider Business Mailing Address
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Address Line | 1032 MOREY PL
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City | LYNCHBURG
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State | VA
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Zip | 24502-2747
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Country | US
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Telephone | 570-898-4707
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701007957
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License Number State | VA
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