| Tanya S. Robertson Lcsw Llc | |
|
5516 Falmouth St Vistas Ii, Suite 102 Richmond VA 23230-1819 | |
| (804) 218-6316 | |
| (804) 282-0012 |
| Full Name | Tanya S. Robertson Lcsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5516 Falmouth St, Richmond, Virginia |
| Authorized Official Name and Position | Tanya S. Robertson (OWNER) |
| Authorized Official Contact | 8042186316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanya S. Robertson Lcsw Llc 5516 Falmouth St Vistas Ii, Suite 102 Richmond VA 23230-1819 Ph: (804) 218-6316 | Tanya S. Robertson Lcsw Llc 5516 Falmouth St Vistas Ii, Suite 102 Richmond VA 23230-1819 Ph: (804) 218-6316 |
| NPI Number | 1932479599 |
|---|---|
| Provider Enumeration Date | 01/12/2012 |
| Last Update Date | 01/12/2012 |
| Medicare PECOS PAC ID | 4587831102 |
|---|---|
| Medicare Enrollment ID | O20120124000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932479599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 0904006220 (Virginia) | Primary |
| Provider Name | Tanya Simmons Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417139015 PECOS PAC ID: 5496922015 Enrollment ID: I20120124000054 |
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