Healthcare Provider Details

I. General information

NPI: 1003797960
Provider Name (Legal Business Name): HEATHER ANGEL HENSLEY LCSW, CAMT, C-DBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER ANGEL ASHBECK LCSW, CAMT, C-DBT

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 COLGRAVE RD
MIDLOTHIAN VA
23112-3768
US

IV. Provider business mailing address

2637 COLGRAVE RD
MIDLOTHIAN VA
23112-3768
US

V. Phone/Fax

Practice location:
  • Phone: 804-419-5079
  • Fax:
Mailing address:
  • Phone: 804-602-5637
  • Fax: 804-331-1830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904018289
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: