Provider Demographics
NPI:1467172478
Name:STAAF, ROBERT JAMES
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:STAAF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 MIDSHIPMAN DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-2423
Mailing Address - Country:US
Mailing Address - Phone:814-823-1850
Mailing Address - Fax:
Practice Address - Street 1:2029 MIDSHIPMAN DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-2423
Practice Address - Country:US
Practice Address - Phone:814-823-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500819271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical