Provider Demographics
NPI:1467472340
Name:HEATON, CHRISTINE KROHL (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KROHL
Last Name:HEATON
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14150 PARKEAST CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-4212
Mailing Address - Country:US
Mailing Address - Phone:703-968-4000
Mailing Address - Fax:
Practice Address - Street 1:14150 PARKEAST CIR STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:20151-4212
Practice Address - Country:US
Practice Address - Phone:703-968-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003784101YM0800X, 101YP2500X
VA0717001095106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist