Provider Demographics
NPI:1043636806
Name:ROBINSON, GAYLE E (PCC-S, LSW)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PCC-S, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2272 COLLINGWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43620-1147
Mailing Address - Country:US
Mailing Address - Phone:419-255-4050
Mailing Address - Fax:419-244-6857
Practice Address - Street 1:2272 COLLINGWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1147
Practice Address - Country:US
Practice Address - Phone:419-255-4050
Practice Address - Fax:419-244-6857
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002151101YP2500X
OHS0006220104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker