Provider Demographics
NPI:1629182480
Name:ROBB, NANCY P (MSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:P
Last Name:ROBB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 WASHINGTON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2150
Mailing Address - Country:US
Mailing Address - Phone:617-527-2855
Mailing Address - Fax:
Practice Address - Street 1:1121 WASHINGTON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2150
Practice Address - Country:US
Practice Address - Phone:617-527-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASW 1007611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22680Medicare ID - Type Unspecified