Healthcare Provider Details

I. General information

NPI: 1710360169
Provider Name (Legal Business Name): GEROPARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SHADY BANKS TER
CHESTERFIELD VA
23832-2501
US

IV. Provider business mailing address

PO BOX 1764
MIDLOTHIAN VA
23113-1764
US

V. Phone/Fax

Practice location:
  • Phone: 855-998-4376
  • Fax: 855-998-4376
Mailing address:
  • Phone: 855-998-4376
  • Fax: 855-998-4376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0904006775
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0810003933
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0810002923
License Number StateVA

VIII. Authorized Official

Name: DR. ANDREW L HECK
Title or Position: PARTNER
Credential: PSYD
Phone: 855-998-4376