Provider Demographics
NPI:1174393078
Name:MCGONIGLE, ROBINANN (NYSPEP-CPE, NCC, MHC)
Entity type:Individual
Prefix:
First Name:ROBINANN
Middle Name:
Last Name:MCGONIGLE
Suffix:
Gender:F
Credentials:NYSPEP-CPE, NCC, MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 CAMBRIDGE AVE RM 326
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4235
Mailing Address - Country:US
Mailing Address - Phone:516-474-8975
Mailing Address - Fax:
Practice Address - Street 1:158 CAMBRIDGE AVE RM 326
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4235
Practice Address - Country:US
Practice Address - Phone:516-474-8975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health