Healthcare Provider Details

I. General information

NPI: 1669971990
Provider Name (Legal Business Name): ROBIN DAVIS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBIN CRAWFORD

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E PARK AVE
NILES OH
44446
US

IV. Provider business mailing address

168 GLUCK ST
YOUNGSTOWN OH
44505-4941
US

V. Phone/Fax

Practice location:
  • Phone: 330-544-8005
  • Fax: 330-544-9379
Mailing address:
  • Phone: 917-645-8754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2304952
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118705
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: