Provider Demographics
NPI:1508290552
Name:CROUCH, ROBYN (MS, NCC, LBS, LPC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:CROUCH
Suffix:
Gender:F
Credentials:MS, NCC, LBS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11676 PERRY HWY STE 2108
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7202
Mailing Address - Country:US
Mailing Address - Phone:412-944-6400
Mailing Address - Fax:412-430-3369
Practice Address - Street 1:11676 PERRY HWY STE 2108
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7202
Practice Address - Country:US
Practice Address - Phone:412-944-6400
Practice Address - Fax:412-430-3369
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008116101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007624160014Medicaid