Provider Demographics
NPI:1770701385
Name:MIDDLETON, ROBERT HUDSON (LCSW, LP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:HUDSON
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:LCSW, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CABRINI BLVD APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1118
Mailing Address - Country:US
Mailing Address - Phone:212-781-2268
Mailing Address - Fax:
Practice Address - Street 1:1449 LEXINGTON AVE STE 4A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2543
Practice Address - Country:US
Practice Address - Phone:212-781-2815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000816-1102L00000X
NYR051909-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical