Healthcare Provider Details

I. General information

NPI: 1427498948
Provider Name (Legal Business Name): CHRISTINE ELISE HEYN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N WASHINGTON ST STE 322
ALEXANDRIA VA
22314-1534
US

IV. Provider business mailing address

4740 20TH RD N UNIT 3106
ARLINGTON VA
22207-2242
US

V. Phone/Fax

Practice location:
  • Phone: 540-845-6940
  • Fax:
Mailing address:
  • Phone: 269-930-0143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number07001007663
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: