Provider Demographics
NPI:1619153046
Name:TAMBONE, ROBERT J (LPC,LMFT,LSATP,NCC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:TAMBONE
Suffix:
Gender:M
Credentials:LPC,LMFT,LSATP,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 S GEORGE MASON DR APT 1306E
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-4727
Mailing Address - Country:US
Mailing Address - Phone:703-671-6988
Mailing Address - Fax:
Practice Address - Street 1:3709 S GEORGE MASON DR APT 1306E
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041
Practice Address - Country:US
Practice Address - Phone:703-671-6988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000068101YA0400X
VA0717000421106H00000X
VA0701002547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist