Provider Demographics
NPI:1477573426
Name:KEYES, HEATHER WILLIAMS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:WILLIAMS
Last Name:KEYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 AVONDALE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-3215
Mailing Address - Country:US
Mailing Address - Phone:434-401-2085
Mailing Address - Fax:
Practice Address - Street 1:4038 THOMAS NELSON HWY
Practice Address - Street 2:
Practice Address - City:ARRINGTON
Practice Address - State:VA
Practice Address - Zip Code:22922-2302
Practice Address - Country:US
Practice Address - Phone:434-263-4000
Practice Address - Fax:434-263-4610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040058701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945441Medicaid
ME143727OtherANTHEM
005458C02Medicare ID - Type Unspecified