Provider Demographics
NPI:1841787066
Name:DOBBINS, JOSEPH LEE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LEE
Last Name:DOBBINS
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 1:2728 HENRY HUDSON PKWY APT 72C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4731
Mailing Address - Country:US
Mailing Address - Phone:860-375-4376
Mailing Address - Fax:
Practice Address - Street 1:2728 HENRY HUDSON PKWY APT 72C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4731
Practice Address - Country:US
Practice Address - Phone:860-375-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0100441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1104959261Medicaid