Provider Demographics
NPI:1528441540
Name:HOULKER ROBLES, KEVIN CHRISTOPHER (LMSW)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:CHRISTOPHER
Last Name:HOULKER ROBLES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-1902
Mailing Address - Country:US
Mailing Address - Phone:718-742-7803
Mailing Address - Fax:
Practice Address - Street 1:804 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1902
Practice Address - Country:US
Practice Address - Phone:718-665-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0674541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY067454OtherNEW YORK STATE OFFICE OF THE PROFESSIONS SOCIAL WORK LICENSE