Provider Demographics
NPI:1467495358
Name:METZ, ROBERT (CSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:METZ
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6217
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10249-6217
Mailing Address - Country:US
Mailing Address - Phone:800-207-5737
Mailing Address - Fax:610-401-2100
Practice Address - Street 1:203 W 12TH ST
Practice Address - Street 2:ROOM 625
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7762
Practice Address - Country:US
Practice Address - Phone:212-604-8803
Practice Address - Fax:212-604-8794
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0428261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical