Provider Demographics
NPI:1124005194
Name:HEYWARD, LOUIS (SOCIAL WORKER)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:
Last Name:HEYWARD
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BLACK OAK CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1800
Mailing Address - Country:US
Mailing Address - Phone:757-826-1263
Mailing Address - Fax:757-314-7576
Practice Address - Street 1:STERNBERG AVENUE
Practice Address - Street 2:BUILDING 515
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604
Practice Address - Country:US
Practice Address - Phone:757-314-7910
Practice Address - Fax:757-314-7576
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical