Provider Demographics
NPI:1174596571
Name:ROBBS, SHAUN EMORY (LCPC)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:EMORY
Last Name:ROBBS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 DOLFIELD AVE APT 119
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7254
Mailing Address - Country:US
Mailing Address - Phone:443-562-0374
Mailing Address - Fax:
Practice Address - Street 1:3412 DOLFIELD AVE APT 119
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7254
Practice Address - Country:US
Practice Address - Phone:443-562-0374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0053101YA0400X
MDLC6406101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)