Provider Demographics
NPI:1548787823
Name:ROBB, ROBERT BRIAN (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRIAN
Last Name:ROBB
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 OAK ALLEY CT STE 201
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1370
Mailing Address - Country:US
Mailing Address - Phone:419-410-3898
Mailing Address - Fax:855-761-1502
Practice Address - Street 1:3454 OAK ALLEY CT STE 201
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1370
Practice Address - Country:US
Practice Address - Phone:419-410-3898
Practice Address - Fax:855-761-1502
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.19015921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0275124Medicaid