Healthcare Provider Details

I. General information

NPI: 1568241982
Provider Name (Legal Business Name): JEAN HEATHER MCPHERSON MA, QMHP-A, CSAC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 S BRADDOCK ST
WINCHESTER VA
22601-4160
US

IV. Provider business mailing address

31 S BRADDOCK ST
WINCHESTER VA
22601-4160
US

V. Phone/Fax

Practice location:
  • Phone: 540-535-1111
  • Fax:
Mailing address:
  • Phone: 757-619-3991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0732010499
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: