MEDICARE: CHARLES BARRAE ROBINSON MSW

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	LC302271	DC
2	1041C0700X	Clinical Social Worker	0904003604	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LC302271	OTHER	DC	LC302271 SOCIAL WORK IND CLINICAL SOCIAL WORKER
2	885121111	OTHER	DC	NATIONAL ASSOCIATION OF SOC. WORKERS: ACSW, DCSW, QCSW
3	0904003604	OTHER	VA	0904003604 LICENSED CLINICAL SOCIAL WORKER

General Provider Information

NPI Number	:	1659325405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES BARRAE ROBINSON MSW

Provider Business Mailing Address
First Line	:	1902 WALKER PLACE
Second Line	:
City	:	COPPERAS COVE
State	:	TX
Zip	:	76522
Country	:	US
Telephone Number	:	254-243-6449
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLDG. 36065, SANTA FE AVE.
Second Line	:	CARL R. DARNE;; ARMY MED CENTER, BEHAVIORAL HEALTH/FAP
City	:	FT. HOOD
State	:	TX
Zip	:	76544-4752
Country	:	US
Telephone Number	:	254-553-1024
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	01/12/2017

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