Provider Demographics
NPI:1396526729
Name:GREENBERG, ROBIN MOSS (LCSW LMFT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MOSS
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 KENNEDY LN
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2036
Mailing Address - Country:US
Mailing Address - Phone:610-203-0702
Mailing Address - Fax:
Practice Address - Street 1:36 E FRONT ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2936
Practice Address - Country:US
Practice Address - Phone:484-238-0204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001298106H00000X
PACW0230301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist