Provider Demographics
NPI:1508657347
Name:ROBINS, PAMELA SUSAN (CSAC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUSAN
Last Name:ROBINS
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9606 GUNSTON HALL RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-9490
Mailing Address - Country:US
Mailing Address - Phone:540-840-1104
Mailing Address - Fax:
Practice Address - Street 1:1200 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4456
Practice Address - Country:US
Practice Address - Phone:540-741-7146
Practice Address - Fax:540-741-7146
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103407101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)