Provider Demographics
NPI:1619122637
Name:ROBSON, AMELIA K (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:K
Last Name:ROBSON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # R031
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-956-1798
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE. RBC #3001
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-7498
Practice Address - Fax:216-844-7960
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00100091041C0700X
OHI.0010009-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0557375OtherGROUP BCMH #
OH72799285Medicaid
OH1003176OtherBCMH