Provider Demographics
NPI:1154547388
Name:DEHAVEN-ROBERTS, ROBIN BETH (LPC,LSATP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:BETH
Last Name:DEHAVEN-ROBERTS
Suffix:
Gender:
Credentials:LPC,LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 BOULDERS PKWY STE 410
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5549
Mailing Address - Country:US
Mailing Address - Phone:048-988-3210
Mailing Address - Fax:
Practice Address - Street 1:1025 BOULDERS PKWY STE 410
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-5549
Practice Address - Country:US
Practice Address - Phone:804-988-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004957101YM0800X
MDLCA404101YA0400X
MDLC1911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701004957OtherLPC
VA0718000237OtherLSATP
TX92806OtherLICENSED PROFESSIONAL COUNSELOR