Healthcare Provider Details

I. General information

NPI: 1700332772
Provider Name (Legal Business Name): ROBERT D LAPP PCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 PARK SQUARE DR STE B
LORAIN OH
44053-4153
US

IV. Provider business mailing address

1925 HAYES AVE
SANDUSKY OH
44870-4737
US

V. Phone/Fax

Practice location:
  • Phone: 440-984-3882
  • Fax: 440-984-3883
Mailing address:
  • Phone: 419-557-5177
  • Fax: 419-557-5179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.0007612
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: