Healthcare Provider Details

I. General information

NPI: 1023941309
Provider Name (Legal Business Name): EAST COAST PSYCHOLOGY GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 CONNECTICUT AVE NW STE 603
WASHINGTON DC
20036-1735
US

IV. Provider business mailing address

1350 CONNECTICUT AVE NW STE 603
WASHINGTON DC
20036-1735
US

V. Phone/Fax

Practice location:
  • Phone: 978-302-9737
  • Fax:
Mailing address:
  • Phone: 978-302-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAURA ROBINSON
Title or Position: OWNER
Credential: PSYD
Phone: 978-302-9737