Healthcare Provider Details

I. General information

NPI: 1245195916
Provider Name (Legal Business Name): RAFT MENTAL HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N COLUMBUS ST
ALEXANDRIA VA
22314-2259
US

IV. Provider business mailing address

400 N COLUMBUS ST
ALEXANDRIA VA
22314-2259
US

V. Phone/Fax

Practice location:
  • Phone: 202-441-4228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SIU-LIN TING ROBINSON
Title or Position: PRESIDENT
Credential: LCSW
Phone: 202-441-4228