Healthcare Provider Details

I. General information

NPI: 1487203766
Provider Name (Legal Business Name): ROBERT SCOTT WILLOUGHBY PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 5TH ST SE STE 6
BARBERTON OH
44203-4257
US

IV. Provider business mailing address

105 5TH ST SE STE 6
BARBERTON OH
44203-4257
US

V. Phone/Fax

Practice location:
  • Phone: 330-745-0081
  • Fax:
Mailing address:
  • Phone: 330-745-0081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP.09006
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: