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NPI Code Detail

MEDICARE: ROBERT ALOYSIUS CRIMMINS LCSW

MEDICARE: ROBERT ALOYSIUS CRIMMINS LCSW
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
11041C0700XClinical Social WorkerSW3326FL

General Provider Information

NPI Number : 1477552297
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT ALOYSIUS CRIMMINS LCSW
Provider Business Mailing Address
First Line : 20 SANDPIPER LN
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-4264
Country : US
Telephone Number : 386-676-1745
Fax Number :
Provider Business Practice Location Address
First Line : 301 JUSTICE LN
Second Line :
City : BUNNELL
State : FL
Zip : 32110-4487
Country : US
Telephone Number : 386-236-3265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 11/15/2021

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