Provider Demographics
NPI:1265916530
Name:ROBINSON, TAY (DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:TAY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 DOGWOOD CIRCLE NORTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3809
Mailing Address - Country:US
Mailing Address - Phone:270-875-1991
Mailing Address - Fax:
Practice Address - Street 1:6330 W 71ST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1784
Practice Address - Country:US
Practice Address - Phone:317-423-1680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker