Provider Demographics
NPI:1831253343
Name:BRANDT, ROBERT (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:BRANDT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DEVONSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3016
Mailing Address - Country:US
Mailing Address - Phone:917-688-9590
Mailing Address - Fax:
Practice Address - Street 1:2101 PARK CENTER DR STE 270
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-7608
Practice Address - Country:US
Practice Address - Phone:407-523-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL139561041C0700X
FLSW139561041C0700X
NY0771341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical