Provider Demographics
NPI:1194359430
Name:HORNER, JOHN LEIGH (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LEIGH
Last Name:HORNER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7431
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-0431
Mailing Address - Country:US
Mailing Address - Phone:804-355-9460
Mailing Address - Fax:
Practice Address - Street 1:700 STOCKTON ST APT 416
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-4188
Practice Address - Country:US
Practice Address - Phone:804-687-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008931101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional