MEDICARE: DR. ANDREW LEE HECK PSY.D.

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	103TC0700X	Clinical Psychologist	0810002923	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0810002923	OTHER	VA	VA PSYCHOLOGY LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366537672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW LEE HECK PSY.D.

Provider Business Mailing Address
First Line	:	1 PARK WEST CIR STE 102
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-5552
Country	:	US
Telephone Number	:	804-993-4304
Fax Number	:	855-998-4376

Provider Business Practice Location Address
First Line	:	1 PARK WEST CIR STE 102
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-5552
Country	:	US
Telephone Number	:	804-993-4304
Fax Number	:	855-998-4376

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/11/2023

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