Provider Demographics
NPI:1548513112
Name:ROBINSON-SURRATT, SUMMER DELORIS (MA, LCASA)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:DELORIS
Last Name:ROBINSON-SURRATT
Suffix:
Gender:F
Credentials:MA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10528 PICKEREL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4827
Mailing Address - Country:US
Mailing Address - Phone:704-224-8333
Mailing Address - Fax:
Practice Address - Street 1:10528 PICKEREL LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4827
Practice Address - Country:US
Practice Address - Phone:704-224-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health