Provider Demographics
NPI:1770556789
Name:WILLINGER, ROBERT STEVEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEVEN
Last Name:WILLINGER
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 1:11 RIVERSIDE DR
Mailing Address - Street 2:3YW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2506
Mailing Address - Country:US
Mailing Address - Phone:212-769-1052
Mailing Address - Fax:
Practice Address - Street 1:11 RIVERSIDE DR
Practice Address - Street 2:3YW
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2506
Practice Address - Country:US
Practice Address - Phone:212-769-1052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR00791111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0001034207OtherMHN
NY01994283Medicaid
NY01994283Medicaid