Provider Demographics
NPI:1245218015
Name:ROBBINS, JEFFREY M (LICSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:M
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:MR
Other - First Name:JEFFREY
Other - Middle Name:M
Other - Last Name:ROBBINS, LICSW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:435 NEWBURY ST.
Mailing Address - Street 2:SUITE 214
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923
Mailing Address - Country:US
Mailing Address - Phone:978-777-6497
Mailing Address - Fax:617-738-9122
Practice Address - Street 1:435 NEWBURY ST
Practice Address - Street 2:SUITE 214
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-777-6497
Practice Address - Fax:617-738-9122
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1018461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical