Provider Demographics
NPI:1659551240
Name:SEPAR, ROBERT (LMSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SEPAR
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 PARK AVE S FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6901
Mailing Address - Country:US
Mailing Address - Phone:917-589-9491
Mailing Address - Fax:
Practice Address - Street 1:475 PARK AVE S FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6901
Practice Address - Country:US
Practice Address - Phone:917-589-9491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073348-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical