Provider Demographics
NPI:1588158406
Name:SMITH, ROBIN (LSCW-R)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LSCW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2243
Mailing Address - Country:US
Mailing Address - Phone:516-423-0940
Mailing Address - Fax:
Practice Address - Street 1:129 DAWN DRIVE
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720
Practice Address - Country:US
Practice Address - Phone:516-423-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical