Healthcare Provider Details

I. General information

NPI: 1457794703
Provider Name (Legal Business Name): NATHAN S HEFNER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 COMMONWEALTH DR
CHARLOTTESVILLE VA
22901-1634
US

IV. Provider business mailing address

2340 COMMONWEALTH DR
CHARLOTTESVILLE VA
22901-1634
US

V. Phone/Fax

Practice location:
  • Phone: 434-249-8416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: