Provider Demographics
NPI:1831298512
Name:ZOSS, ROBIN BUBIS (MSSA LISW)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:BUBIS
Last Name:ZOSS
Suffix:
Gender:F
Credentials:MSSA LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 ORANGE PLACE
Mailing Address - Street 2:#430
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-464-5330
Mailing Address - Fax:216-464-5332
Practice Address - Street 1:3690 ORANGE PLACE
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-464-5330
Practice Address - Fax:216-464-5332
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI4645104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI4645OtherOHIO STATE LICENSE
Z0SW12482Medicare UPIN
OHZ0SW12482Medicare ID - Type Unspecified