Jenna-Paix Robertson, CLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

315760 Issued in VA

Practice address

5741 Cleveland St Ste 150
Virginia Beach, VA 23462-1777

Phone

(757) 422-5502

NPI assigned

Apr 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tidewater Lactation Group, Inc.

  • Lactation Consultant (Registered Nurse)
  • Virginia Beach, VA
  • NPI 1790999621
  NPD

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1811639057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 CLEVELAND ST STE 150",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621777",
            "telephone_number": "757-422-5502",
            "fax_number": "757-455-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5741 CLEVELAND ST STE 150",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621777",
            "telephone_number": "757-422-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JENNA-PAIX",
        "name_prefix": "Mrs.",
        "credential": "CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "VA",
            "license": "316744",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "315760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan A Roberts
• Trevor Roberts
• Courtney Brooke Robertson, PA-C
• Heather Yanni Robertson, M.A., CCC-SLP
• Jacqueline Ann Robertson
• Shawna Robertson, LMT
• Edwin L. Robey, M.D.
• Robins Consulting, PLLC
• Julian Robins
• Laura Lee Robins, MS OTRL

• Specialist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.