Healthcare Provider Details

I. General information

NPI: 1396062410
Provider Name (Legal Business Name): ROBERT ALLEN ERB LSW, LICDC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 CLOCKTOWER DR
KIRTLAND OH
44094-5198
US

IV. Provider business mailing address

12185 PARKER DR
CHESTERLAND OH
44026-1912
US

V. Phone/Fax

Practice location:
  • Phone: 216-233-7269
  • Fax:
Mailing address:
  • Phone: 216-233-7269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number091116
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS0021277
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: