Provider Demographics
NPI:1972909737
Name:CAPPER, ROBIN A (LSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:CAPPER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:A
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1805
Mailing Address - Country:US
Mailing Address - Phone:330-453-8252
Mailing Address - Fax:330-453-6716
Practice Address - Street 1:1207 W STATE ST STE F
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4686
Practice Address - Country:US
Practice Address - Phone:330-821-3846
Practice Address - Fax:330-821-5172
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0030680104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2584314Medicaid