Provider Demographics
NPI:1508310285
Name:HEEBNER, DAVID C (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:C
Last Name:HEEBNER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14143 ROBERT PARIS CT
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-4201
Mailing Address - Country:US
Mailing Address - Phone:703-815-1199
Mailing Address - Fax:
Practice Address - Street 1:14143 ROBERT PARIS CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-4201
Practice Address - Country:US
Practice Address - Phone:703-815-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003729101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor