Provider Demographics
NPI:1245713452
Name:STEGGERT, ROBERT DIETRICH (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DIETRICH
Last Name:STEGGERT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:STEGGERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:256 W 123RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5736
Mailing Address - Country:US
Mailing Address - Phone:917-749-5468
Mailing Address - Fax:
Practice Address - Street 1:256 W 123RD ST APT 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5736
Practice Address - Country:US
Practice Address - Phone:917-749-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106899104100000X
390200000X
NY0940911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program