Provider Demographics
NPI:1366003360
Name:CLEVELAND, ROBIN (PHD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1014
Mailing Address - Country:US
Mailing Address - Phone:703-864-5095
Mailing Address - Fax:
Practice Address - Street 1:5830 COLFAX AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1014
Practice Address - Country:US
Practice Address - Phone:703-864-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC15143101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor