Provider Demographics
NPI:1649519927
Name:GOLDSTEIN, ROBIN MARTA (LSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARTA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MARTA
Other - Last Name:TINNEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:1667 AXEL AVE
Mailing Address - Street 2:
Mailing Address - City:N BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1402
Mailing Address - Country:US
Mailing Address - Phone:732-236-5573
Mailing Address - Fax:
Practice Address - Street 1:1667 AXEL AVE
Practice Address - Street 2:
Practice Address - City:N BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1402
Practice Address - Country:US
Practice Address - Phone:732-236-5573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05521700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker