Individual provider Active NPI

Sybil Robertson, LCSW

  • Clinical Social Worker
  • Midlothian, VA
National Provider Identifier
1306035795
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006291 Issued in VA
Practice address
5309 Commonwealth Centre Pkwy Ste 401
Midlothian, VA 23112-2633
Phone
(804) 819-4000
Fax
(804) 819-4268
NPI assigned
Oct 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904006291 VA Primary

Addresses

Primary practice location

5309 Commonwealth Centre Pkwy Ste 401
Midlothian, VA 23112-2633

Mailing address

16425 Ravenchase Way
Moseley, VA 23120-0019
Phone (804) 647-1198

Other identifiers 2

IdentifierTypeStateIssuer
1306035795MedicaidVA
4945255MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122002402 VA Practitioner - Clinical Social Worker 9133408792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006291VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Behavioral Health, PLLC Clinical CurrentSince Sep 27, 2016 Accepting new patients
Robertson Counseling, PLLC Clinical CurrentSince Aug 17, 2025 Accepting new patients
Ephratah Health Group LLC PastSince Dec 1, 2025 Accepting new patients

Locations

5309 Commonwealth Centre Pkwy
Ste 401
Midlothian, VA 23112
Phone (804) 465-9311

6500 Woodlake Village Cir
Midlothian, VA 23112
Phone (804) 823-5475

6504 Woodlake Village Cir
Midlothian, VA 23112
Phone (804) 601-3653

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1306035795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16425 RAVENCHASE WAY",
            "city": "MOSELEY",
            "state": "VA",
            "postal_code": "231200019",
            "telephone_number": "804-647-1198",
            "fax_number": "804-647-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 COMMONWEALTH CENTRE PKWY STE 401",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122633",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SYBIL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306035795",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4945255",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.