Provider Demographics
NPI:1326117037
Name:HEDRICK, WILLIAM C (DMIN)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:HEDRICK
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1810
Mailing Address - Country:US
Mailing Address - Phone:757-623-2700
Mailing Address - Fax:757-640-1058
Practice Address - Street 1:800 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1810
Practice Address - Country:US
Practice Address - Phone:757-623-2700
Practice Address - Fax:757-640-1058
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701000401OtherLICENSED PROF. COUNSELOR
VA0717000245OtherLIC MARRIAGE & FAM THERAP