Healthcare Provider Details

I. General information

NPI: 1881082832
Provider Name (Legal Business Name): AMY TUTHILL HEPNER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY KATHRYN TUTHILL LPC, NCC

II. Dates (important events)

Enumeration Date: 12/29/2014
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 FIRST COLONIAL RD SUITE #1820
VIRGINIA BEACH VA
23454-3182
US

IV. Provider business mailing address

6330 NEWTOWN RD SUITE #300
NORFOLK VA
23502-4802
US

V. Phone/Fax

Practice location:
  • Phone: 757-422-5222
  • Fax:
Mailing address:
  • Phone: 757-466-3336
  • Fax: 757-455-5750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701005930
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: