MEDICARE: ROBIN LAWRENCE

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1447731575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN LAWRENCE

Provider Business Mailing Address
First Line	:	1498 REISTERSTOWN RD STE 105
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-3817
Country	:	US
Telephone Number	:	443-334-5732
Fax Number	:

Provider Business Practice Location Address
First Line	:	1498 REISTERSTOWN RD STE 105
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-3817
Country	:	US
Telephone Number	:	443-292-2246
Fax Number	:

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

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	10/21/2020

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