Provider Demographics
NPI:1952038531
Name:ROBINSON, KEYNICA M
Entity type:Individual
Prefix:
First Name:KEYNICA
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 SMITH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3701
Mailing Address - Country:US
Mailing Address - Phone:410-777-5895
Mailing Address - Fax:509-634-2607
Practice Address - Street 1:1340 SMITH AVE FL 3
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3701
Practice Address - Country:US
Practice Address - Phone:410-777-5895
Practice Address - Fax:509-634-2607
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT2576101Y00000X
MDLC16463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor