Robert Wayne Sutak, L.I.S.W-S.
Individual provider Active NPI Clinical Social Worker · New Middletown, OH
NPI 1770545543 · NPPES record last updated May 13, 2009
Key facts
- NPI
- 1770545543
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I0009404 (OH)
- Practice address
- 10391 Midway Drive
New Middletown, OH 44442 - Phone
- (330) 501-9319
- Fax
- (330) 366-0312
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I0009404 | OH | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | I0009404 | OH | |
| Clinical Social Worker | 1041C0700X | I0009404 | OH | Yes |
Addresses
Primary practice location
10391 Midway Drive
New Middletown, OH 44442
Mailing address
10391 Midway Drive
New Middletown, OH 44442
Phone (330) 501-9319
Other providers in New Middletown, OH
- Richard G Wise DO Inc
- Carrie Lynn Ritzler
- Mindy A Ritzler
- Nicole Saborse
- Springfield Local School District
- Ashleigh Talerico
- Tracey M Tatar
- Allyson Turnbull
- Village of New Middletown
- Jackie Willoughby
All providers in New Middletown, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.