Provider Demographics
NPI:1588396485
Name:LEWIS, ROBIN ANGELA DIONNE (LMSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANGELA DIONNE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 CHURCH AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3484
Mailing Address - Country:US
Mailing Address - Phone:718-600-7029
Mailing Address - Fax:
Practice Address - Street 1:717 CHURCH AVE APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3484
Practice Address - Country:US
Practice Address - Phone:718-600-7029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11336301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical