Healthcare Provider Details

I. General information

NPI: 1043135775
Provider Name (Legal Business Name): SAMANTHA ROBINSON M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N WASHINGTON ST STE 100
FALLS CHURCH VA
22046-3538
US

IV. Provider business mailing address

6305 FIELD FLOWER TRL
CENTREVILLE VA
20121-5626
US

V. Phone/Fax

Practice location:
  • Phone: 571-234-1697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0704019172
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: