Provider Demographics
NPI:1083202337
Name:EGGINTON, ROB (LCSW)
Entity Type:Individual
Prefix:
First Name:ROB
Middle Name:
Last Name:EGGINTON
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 1:28 GILBERT ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4559
Mailing Address - Country:US
Mailing Address - Phone:914-396-8299
Mailing Address - Fax:
Practice Address - Street 1:28 GILBERT ST APT 3B
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4559
Practice Address - Country:US
Practice Address - Phone:914-396-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0906201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical