Provider Demographics
NPI:1740358233
Name:CRAIN, ROBBI (PSYD, HSPP)
Entity type:Individual
Prefix:DR
First Name:ROBBI
Middle Name:
Last Name:CRAIN
Suffix:
Gender:F
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 823
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107
Mailing Address - Country:US
Mailing Address - Phone:317-780-5750
Mailing Address - Fax:317-780-5755
Practice Address - Street 1:6249 S EAST ST
Practice Address - Street 2:SUITE I
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2091
Practice Address - Country:US
Practice Address - Phone:317-780-5750
Practice Address - Fax:317-780-5755
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042288A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200939250Medicaid