Provider Demographics
NPI:1679656375
Name:HALL, ROBIN LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 E CORAL KY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4402
Mailing Address - Country:US
Mailing Address - Phone:757-498-5002
Mailing Address - Fax:
Practice Address - Street 1:289 INDEPENDENCE BLVD
Practice Address - Street 2:PEMBROKE 3 SUITE 138
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5493
Practice Address - Country:US
Practice Address - Phone:757-437-6150
Practice Address - Fax:757-671-8536
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040027391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA270004OtherANTHEM
VA088056OtherOPTIMA
VA009710C34Medicare ID - Type UnspecifiedMEDICARE PART B