Healthcare Provider Details

I. General information

NPI: 1689979494
Provider Name (Legal Business Name): HEATHER VAN HORN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8270 WILLOW OAKS CORPORATE DR
FAIRFAX VA
22031-4530
US

IV. Provider business mailing address

47126 SOUTHAMPTON CT
STERLING VA
20165-7507
US

V. Phone/Fax

Practice location:
  • Phone: 703-307-1619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberPPS-0606036
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: