Provider Demographics
NPI:1245500834
Name:MEYER, ROBERT (LMSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MEYER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 W 116TH ST
Mailing Address - Street 2:APT. 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:313 W 116TH ST
Practice Address - Street 2:APT. 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2092
Practice Address - Country:US
Practice Address - Phone:516-319-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085564104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker