Provider Demographics
NPI:1477552297
Name:CRIMMINS, ROBERT ALOYSIUS (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALOYSIUS
Last Name:CRIMMINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4264
Mailing Address - Country:US
Mailing Address - Phone:386-676-1745
Mailing Address - Fax:
Practice Address - Street 1:301 JUSTICE LN
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-4487
Practice Address - Country:US
Practice Address - Phone:386-236-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW33261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical