MEDICARE: HEIDI FERN KIRKWOOD

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	0701012075	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619496775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI FERN KIRKWOOD

Provider Business Mailing Address
First Line	:	1037 SWAPSCOTT CT # 1037
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6725
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1037 SWAPSCOTT CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6725
Country	:	US
Telephone Number	:	252-339-8357
Fax Number	:

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

Provider Enumeration Date	:	09/11/2017
Last Update Date	:	02/13/2026

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Directions to “ HEIDI FERN KIRKWOOD ” Practice Location

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