Provider Demographics
NPI:1255606133
Name:LEN, ROBERT CHARLES (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHARLES
Last Name:LEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DEPOT PLZ
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1827
Mailing Address - Country:US
Mailing Address - Phone:914-819-0703
Mailing Address - Fax:
Practice Address - Street 1:2 DEPOT PLZ
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1827
Practice Address - Country:US
Practice Address - Phone:914-819-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081530104100000X
1041C0700X
NY0828311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker