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NPI Code Detail

MEDICARE: ROBYN DANIELLE CRUMPACKER MSW, LCSW, LCACA

MEDICARE: ROBYN DANIELLE CRUMPACKER MSW, LCSW, LCACA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor87900021AIN
21041C0700XClinical Social Worker34009458AIN

General Provider Information

NPI Number : 1427616721
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBYN DANIELLE CRUMPACKER MSW, LCSW, LCACA
Provider Business Mailing Address
First Line : 6081 E TERHUNE CT
Second Line :
City : CAMBY
State : IN
Zip : 46113-9634
Country : US
Telephone Number : 765-721-6134
Fax Number :
Provider Business Practice Location Address
First Line : 7550 S MERIDIAN ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-2912
Country : US
Telephone Number : 317-992-1919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2019
Last Update Date : 10/27/2021

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