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General NPI Number Information
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NPI Number | 1720307689
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Entity Type | Individual
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Provider Name | MICHAEL THEODORE HESTER LCP, LCPC, LPN
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Gender | Male
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 1359 W 40TH ST
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City | NORFOLK
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State | VA
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Zip | 23508-2340
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Country | US
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Telephone | 757-533-1399
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Fax |
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Provider Business Mailing Address
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Address Line | 1359 W 40TH ST # A
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City | NORFOLK
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State | VA
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Zip | 23508-2340
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Country | US
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Telephone | 757-533-1399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC005961
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC3472
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1003-0705
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | LPN070659
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701010939
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License Number State | VA
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