Healthcare Provider Details

I. General information

NPI: 1306035795
Provider Name (Legal Business Name): SYBIL ROBERTSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5309 COMMONWEALTH CENTRE PKWY STE 401
MIDLOTHIAN VA
23112-2633
US

IV. Provider business mailing address

16425 RAVENCHASE WAY
MOSELEY VA
23120-0019
US

V. Phone/Fax

Practice location:
  • Phone: 804-819-4000
  • Fax: 804-819-4268
Mailing address:
  • Phone: 804-647-1198
  • Fax: 804-647-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904006291
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: