MEDICARE: MICHELLE NICOLE ROBINSON LCSW

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	1041C0700X	Clinical Social Worker	10592	LA

General Provider Information

NPI Number	:	1265916159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE NICOLE ROBINSON LCSW

Provider Business Mailing Address
First Line	:	197 TYSON GLEN DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-2316
Country	:	US
Telephone Number	:	318-451-6787
Fax Number	:

Provider Business Practice Location Address
First Line	:	2052 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3625
Country	:	US
Telephone Number	:	478-207-7773
Fax Number	:	877-299-6815

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

Provider Enumeration Date	:	09/18/2018
Last Update Date	:	05/14/2025

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