MEDICARE: HEATHER L. MAZEY MS, CSAC, LPC-R(VA)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor		VA
2	101YM0800X	Mental Health Counselor		VA

General Provider Information

NPI Number	:	1215882238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER L. MAZEY MS, CSAC, LPC-R(VA)

Provider Business Mailing Address
First Line	:	1320 CENTRAL PARK BLVD STE 412
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-4959
Country	:	US
Telephone Number	:	540-412-8613
Fax Number	:	540-566-5151

Provider Business Practice Location Address
First Line	:	1320 CENTRAL PARK BLVD STE 412
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-4959
Country	:	US
Telephone Number	:	540-412-8613
Fax Number	:	540-566-5151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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