Provider Demographics
NPI:1598912057
Name:ROBERTSON, DOROTHEA (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:DOROTHEA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W DURWOOD CRES
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6703
Mailing Address - Country:US
Mailing Address - Phone:804-288-4826
Mailing Address - Fax:
Practice Address - Street 1:1000 W DURWOOD CRES
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6703
Practice Address - Country:US
Practice Address - Phone:804-288-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health