Provider Demographics
NPI:1427616721
Name:CRUMPACKER, ROBYN DANIELLE (MSW, LCSW, LCACA)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:DANIELLE
Last Name:CRUMPACKER
Suffix:
Gender:F
Credentials:MSW, LCSW, LCACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6081 E TERHUNE CT
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-9634
Mailing Address - Country:US
Mailing Address - Phone:765-721-6134
Mailing Address - Fax:
Practice Address - Street 1:7550 S MERIDIAN ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-2912
Practice Address - Country:US
Practice Address - Phone:317-992-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87900021A101YA0400X
IN34009458A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)