Provider Demographics
NPI:1013119510
Name:ROBBINS, CHARLES L (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SEWARD LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3108
Mailing Address - Country:US
Mailing Address - Phone:631-689-5163
Mailing Address - Fax:
Practice Address - Street 1:3 SEWARD LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3108
Practice Address - Country:US
Practice Address - Phone:631-689-5163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0198311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical