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General NPI Number Information
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NPI Number | 1558579581
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Entity Type | Individual
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Provider Name | SHELLEY ROBIN GREENBAUM LISW,LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 111 FARRIS ST TRLR 37
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City | CARLSBAD
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State | NM
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Zip | 88220-5946
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Country | US
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Telephone | 505-885-4001
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Fax | 505-887-6437
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Provider Business Mailing Address
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Address Line | 111 FARRIS ST TRLR 37
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City | CARLSBAD
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State | NM
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Zip | 88220-5946
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Country | US
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Telephone | 505-885-4001
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Fax | 505-887-6437
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I-3442
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License Number State | NM
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