Healthcare Provider Details

I. General information

NPI: 1619571882
Provider Name (Legal Business Name): ANTHONY ROBINSON JR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2020
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S PAYNE ST
ALEXANDRIA VA
22314-2939
US

IV. Provider business mailing address

200 N GLEBE RD STE 104
ARLINGTON VA
22203-3755
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax: 571-297-9809
Mailing address:
  • Phone: 703-841-0703
  • Fax: 571-297-9809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904012463
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: