Healthcare Provider Details

I. General information

NPI: 1003438318
Provider Name (Legal Business Name): SKYLER GRACE HESTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SKYLER FRANZEN

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 01/30/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 LIGHT BOULEVARD
FOREST VA
24551
US

IV. Provider business mailing address

3404 WILSON AVE
LYNCHBURG VA
24501-6221
US

V. Phone/Fax

Practice location:
  • Phone: 888-808-6050
  • Fax:
Mailing address:
  • Phone: 518-948-9353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number0110910
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017773
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: