Individual provider Active NPI

Robin E Dock, PH.D., LPC, CRC

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1962436295
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC9895 Issued in NC
Practice address
3410 Healy Dr
Suite 203
Winston Salem, NC 27103-1403
Phone
(336) 774-0006
NPI assigned
Jul 11, 2006
Last updated
Apr 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC003265 GA
Rehabilitation Counselor 225C00000X C-036617 GA
Professional Counselor 101YP2500X LPC9895 NC Primary

Addresses

Primary practice location

3410 Healy Dr
Suite 203
Winston Salem, NC 27103-1403

Mailing address

3410 Healy Dr
Suite 203
Winston Salem, NC 27103-1403
Phone (678) 614-3211

Other identifiers 1

IdentifierTypeStateIssuer
557746581AMedicaidGA

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC003265GAMDProfessional Counselor
LPC9895NCMDProfessional Counselor
C-036617GAMDRehabilitation Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Robin E Dock PHD Past 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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1962436295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 HEALY DR",
            "address_2": "SUITE 203",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031403",
            "telephone_number": "678-614-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 HEALY DR",
            "address_2": "SUITE 203",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031403",
            "telephone_number": "336-774-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCK",
        "first_name": "ROBIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003265",
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "GA",
            "license": "C-036617",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "LPC9895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "557746581A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.