Robert Wayne Sutak, L.I.S.W-S.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0009404 Issued in OH

Practice address

10391 Midway Drive
New Middletown, OH 44442

Phone

(330) 501-9319

Fax

(330) 366-0312

NPI assigned

Apr 5, 2006

Last updated

May 13, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1770545543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10391 MIDWAY DRIVE",
            "city": "NEW MIDDLETOWN",
            "state": "OH",
            "postal_code": "44442",
            "telephone_number": "330-501-9319",
            "fax_number": "330-366-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10391 MIDWAY DRIVE",
            "city": "NEW MIDDLETOWN",
            "state": "OH",
            "postal_code": "44442",
            "telephone_number": "330-501-9319",
            "fax_number": "330-366-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTAK",
        "first_name": "ROBERT",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "L.I.S.W-S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I0009404",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0009404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard G Wise DO Inc
• Carrie Lynn Ritzler
• Mindy A Ritzler
• Nicole Saborse
• Springfield Local School District
• Ashleigh Talerico, PMHNP, FNP
• Tracey M Tatar, RN
• Allyson Turnbull, M.A., CCC-SLP
• Village of New Middletown
• Jackie Willoughby

• Clinical Social Worker in New Middletown, OH
• Providers in New Middletown, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.