Provider Demographics
NPI:1366088908
Name:ROBINSON, DAMON L (MCJ)
Entity type:Individual
Prefix:
First Name:DAMON
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MCJ
Other - Prefix:MR
Other - First Name:DAMON
Other - Middle Name:L
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MCJ
Mailing Address - Street 1:2330 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-3612
Mailing Address - Country:US
Mailing Address - Phone:319-899-8562
Mailing Address - Fax:
Practice Address - Street 1:317 7TH AVE SE STE 203
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2007
Practice Address - Country:US
Practice Address - Phone:319-247-4873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)