Provider Demographics
NPI:1568213452
Name:TIMMINS, ROBERT E (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:TIMMINS
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 1:300 JAY ST # L-236
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1909
Mailing Address - Country:US
Mailing Address - Phone:347-424-6395
Mailing Address - Fax:718-254-8539
Practice Address - Street 1:3310 NOSTRAND AVE APT 604
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3273
Practice Address - Country:US
Practice Address - Phone:347-424-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0919101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical