Provider Demographics
NPI:1083039903
Name:EUTZ, ROBIN (PHD, LCAC, LICDC-CS)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:EUTZ
Suffix:
Gender:F
Credentials:PHD, LCAC, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9226 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1120
Mailing Address - Country:US
Mailing Address - Phone:317-523-8963
Mailing Address - Fax:
Practice Address - Street 1:5555 N TACOMA AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3512
Practice Address - Country:US
Practice Address - Phone:317-523-8963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000274A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)