Provider Demographics
NPI:1619571882
Name:ROBINSON, ANTHONY JR (LCSW)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:ROBINSON
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S COURTHOUSE RD APT 2142
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1979
Mailing Address - Country:US
Mailing Address - Phone:225-229-9803
Mailing Address - Fax:
Practice Address - Street 1:108 S COURTHOUSE RD APT 2142
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1979
Practice Address - Country:US
Practice Address - Phone:225-229-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040124631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904012463OtherDEPARTMENT OF HEALTH PROFESSIONS