Jennifer Lynn Robertson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04544 Issued in MD

Practice address

50 W Montgomery Ave
Suite 110 a
Rockville, MD 20850-4216

Phone

(301) 251-8965

Fax

(301) 251-0136

NPI assigned

Jun 30, 2008

Last updated

Jun 30, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Ms. Jennifer Blood Robertson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1063674117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 TWEED ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208511426",
            "telephone_number": "301-922-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE",
            "address_2": "SUITE 110 A",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504216",
            "telephone_number": "301-251-8965",
            "fax_number": "301-251-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04544",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003931",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROBERTSON",
            "middle_name": "BLOOD",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Morgan Roberts
• Sophia Kourtis Roberts, MS, CCC-SLP
• Yvette Roberts
• Auje Robertson-Mack
• Daniel S Robertson, MD
• Malikah Robertson
• Diriba Robi
• Mattie Robinsom
• George Robinson Jr
• Selena Robinson-Clipper

• Clinical Psychologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.