Provider Demographics
NPI:1396812392
Name:THROCKMORTON, ROBIN ROSS (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ROSS
Last Name:THROCKMORTON
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 1:117 ORANGE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1347
Mailing Address - Country:US
Mailing Address - Phone:804-243-4291
Mailing Address - Fax:888-330-2156
Practice Address - Street 1:117 ORANGE AVE STE C
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1347
Practice Address - Country:US
Practice Address - Phone:804-243-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040044181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010302587Medicaid
VA1396812392OtherANTHEM
VA54-1743715OtherVA HEALTH NETWORK
VA1396812392OtherVIRGINIA PREMIER
VA1396812392OtherMAGELLAN
VA255066000OtherMAGELLEN
VA308367OtherUBH
VA7393235OtherAETNA
VA81733OtherALLIANCE
VA137524OtherVALUE OPTIONS
VA1396812392OtherMHNET
VA0007393235OtherAETNA
VA1396812392OtherUNITED BEHAVIORAL HEALTH
VAIP513476OtherTRICARE
VA202238OtherANTHEM HEALTHKEEPERS
VA5680530OtherCIGNA
VA81733OtherSENTARA
VACO3871OtherMEDICARE GROUP NUMBER
VA081733OtherSENTARA
VA81733OtherOPTIMA
VA1396812392OtherCARENET
VA202238OtherANTHEM BCBS
VA2328606OtherCIGNA
VA54-1206217OtherTRICARE
VA1396812392Medicaid
VA81733OtherSENTARA
VA543518Medicare UPIN