Tina M Robertson, LCAC, LSW

NPI #1861720872 in Elkhart, Indiana

Provider Information

NPI Number: 1861720872
Entity Type: Individual
Name: Tina M Robertson, LCAC, LSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LCAC, LSW
Enumeration Date: Dec 2, 2009
Last Updated: Apr 6, 2012

Practice Location

Address: 2600 OAKLAND AVE
City: Elkhart
State: Indiana
ZIP Code: 46517-1533
Phone: (574) 533-1234

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor	101Y00000X
Social Worker	104100000X	Primary

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