Provider Demographics
NPI:1679697817
Name:ROBINSON, BRENDA TWYNER (MSW)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:TWYNER
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 PEACHTREE STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30361
Mailing Address - Country:US
Mailing Address - Phone:404-403-4806
Mailing Address - Fax:404-270-5297
Practice Address - Street 1:1201 PEACHTREE STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30361
Practice Address - Country:US
Practice Address - Phone:404-403-4806
Practice Address - Fax:404-270-5297
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0008271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical