Basic Information
Provider Information
NPI: 1841345568
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DILL
FirstName: ROBERT
MiddleName: STEVEN
NamePrefix: MR.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: KAISER PERMANENTE, PPQA, 6 WEST
City: ROCKVILLE
State: MD
PostalCode: 20852
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 201 N WASHINGTON ST
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220464518
CountryCode: US
TelephoneNumber: 7032374000
FaxNumber: 7035311537
Other Information
ProviderEnumerationDate: 01/24/2007
LastUpdateDate: 12/28/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0710001048VAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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