Provider Demographics
NPI:1962033522
Name:ROBINSON, JEREMY (LMFT)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 86TH ST STE 222
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3412
Mailing Address - Country:US
Mailing Address - Phone:818-633-8929
Mailing Address - Fax:
Practice Address - Street 1:49 W 24TH ST STE 612
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3206
Practice Address - Country:US
Practice Address - Phone:323-607-4724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139884106H00000X
NY001630106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist