Provider Demographics
NPI:1568241982
Name:MCPHERSON, JEAN HEATHER (MA, QMHP-A, CSAC-A)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:HEATHER
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:MA, QMHP-A, CSAC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S BRADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4160
Mailing Address - Country:US
Mailing Address - Phone:757-619-3991
Mailing Address - Fax:
Practice Address - Street 1:31 S BRADDOCK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4160
Practice Address - Country:US
Practice Address - Phone:540-535-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0734004873101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health