Provider Demographics
NPI:1356492722
Name:MARGOLIS, ROBERT I (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:I
Last Name:MARGOLIS
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 1:1927 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1340
Mailing Address - Country:US
Mailing Address - Phone:516-318-0949
Mailing Address - Fax:516-342-1897
Practice Address - Street 1:1097 OLD COUNTRY RD STE 105
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6505
Practice Address - Country:US
Practice Address - Phone:516-318-0949
Practice Address - Fax:516-342-1897
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0334541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical