Provider Demographics
NPI:1497479588
Name:HARTRIDGE, KEVEATTE L (LPC)
Entity Type:Individual
Prefix:
First Name:KEVEATTE
Middle Name:L
Last Name:HARTRIDGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6345 CENTER DR BLDG 14
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4126
Mailing Address - Country:US
Mailing Address - Phone:757-467-8184
Mailing Address - Fax:757-282-2992
Practice Address - Street 1:6345 CENTER DR BLDG 14
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4126
Practice Address - Country:US
Practice Address - Phone:757-467-8184
Practice Address - Fax:757-282-2992
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011766101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health