Provider Demographics
NPI:1780336743
Name:ROBINSON, CASSIDY GRAY (MS, NCC, CCTSI)
Entity type:Individual
Prefix:MS
First Name:CASSIDY
Middle Name:GRAY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, NCC, CCTSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 HICKORY PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2628
Mailing Address - Country:US
Mailing Address - Phone:757-636-4800
Mailing Address - Fax:
Practice Address - Street 1:5230 HICKORY PARK DR STE A
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-2628
Practice Address - Country:US
Practice Address - Phone:757-636-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health