Provider Demographics
NPI:1063274439
Name:BABICH, ROBERT S (MS MHC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:BABICH
Suffix:
Gender:M
Credentials:MS MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 CLINTONVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1231
Mailing Address - Country:US
Mailing Address - Phone:917-364-1634
Mailing Address - Fax:
Practice Address - Street 1:917 CLINTONVILLE ST FL 2
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1231
Practice Address - Country:US
Practice Address - Phone:917-364-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014103-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health