Provider Demographics
NPI:1013274992
Name:GALVIN, ROBERT PATRICK
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:GALVIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:
Other - Last Name:GALVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:57 PROSPECT PARK SW
Mailing Address - Street 2:APT 4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5968
Mailing Address - Country:US
Mailing Address - Phone:917-617-8743
Mailing Address - Fax:
Practice Address - Street 1:57 PROSPECT PARK SW
Practice Address - Street 2:APT 4A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5968
Practice Address - Country:US
Practice Address - Phone:917-617-8743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0709791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical