Provider Demographics
NPI:1689715872
Name:SERBIN, RICHARD ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:SERBIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MELBOURNE CIR SW
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-8916
Mailing Address - Country:US
Mailing Address - Phone:330-877-9818
Mailing Address - Fax:
Practice Address - Street 1:900 MULL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7502
Practice Address - Country:US
Practice Address - Phone:330-867-5603
Practice Address - Fax:330-873-3439
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001309101YP2500X
OH5447103T00000X
GAPSY002188103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000211581OtherANTHEM BC-BS
065231000OtherMAGELLAN BEHAVIORAL
341213335RSOtherSUMMACARE
6188851OtherUNITED BEHAVIORAL HEALTH
7957662OtherOH DEPT JOB & FAM SERV
SECP22221OtherPALMETTO GBA
250575OtherVALUE OPTIONS