Individual provider Active NPI

Mayra Edith Robinson, MSW, LCSWA, LCASA

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1336860287
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P018034 Issued in NC
Practice address
951 S McPherson Church Rd
Fayetteville, NC 28303-5184
Phone
(910) 849-3399
Fax
(910) 900-0913
NPI assigned
Sep 8, 2022
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-27921 NC
Clinical Social Worker 1041C0700X P018034 NC Primary

Addresses

Primary practice location

951 S McPherson Church Rd
Fayetteville, NC 28303-5184

Mailing address

256 Ramona Dr
Fayetteville, NC 28303-1954
Phone (910) 644-4217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-27921NCMDAddiction (Substance Use Disorder) Counselor
P018034NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inspiring Change PLLC Addiction (Substance Use Disorder) PastSince Jul 28, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1336860287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 RAMONA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283031954",
            "telephone_number": "910-644-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 S MCPHERSON CHURCH RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035184",
            "telephone_number": "910-849-3399",
            "fax_number": "910-900-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MAYRA",
        "middle_name": "EDITH",
        "credential": "MSW, LCSWA, LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-27921",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.