Provider Demographics
NPI:1912008046
Name:COSTANZO, ROBYN (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:COSTANZO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:LERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:41 UNION SQ W
Mailing Address - Street 2:#1328
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3236
Mailing Address - Country:US
Mailing Address - Phone:917-618-2363
Mailing Address - Fax:
Practice Address - Street 1:41 UNION SQ W
Practice Address - Street 2:#1328
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3236
Practice Address - Country:US
Practice Address - Phone:917-618-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0778681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical