Healthcare Provider Details

I. General information

NPI: 1124436340
Provider Name (Legal Business Name): KRISZTINA HEGEDUS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 E GARRISON BLVD STE A
GASTONIA NC
28054-5155
US

IV. Provider business mailing address

900 COPPERFIELD BLVD NE
CONCORD NC
28025-2433
US

V. Phone/Fax

Practice location:
  • Phone: 704-833-0154
  • Fax: 704-833-7076
Mailing address:
  • Phone: 704-721-0000
  • Fax: 704-973-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP011333
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: