MEDICARE: ROBYN SUMMERS GRUBER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	004847	GA
2	101YP2500X	Professional Counselor	LPC004847	GA

General Provider Information

NPI Number	:	1144551037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN SUMMERS GRUBER LPC

Provider Business Mailing Address
First Line	:	3535 ROSWELL RD STE 29
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8829
Country	:	US
Telephone Number	:	678-665-8455
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ROSWELL RD STE 29
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8829
Country	:	US
Telephone Number	:	678-665-8455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2010
Last Update Date	:	08/05/2025

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