Provider Demographics
NPI:1124440565
Name:STULL, ROBIN ELIZABETH (LPCC-S)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:STULL
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:MISS
Other - First Name:ROBIN
Other - Middle Name:ELIZABETH
Other - Last Name:CAUDILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2228 HAYES AVE STE D
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-2699
Mailing Address - Country:US
Mailing Address - Phone:419-635-6624
Mailing Address - Fax:
Practice Address - Street 1:2228 HAYES AVE STE D
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2699
Practice Address - Country:US
Practice Address - Phone:419-635-6624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-18
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1300332101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor