Provider Demographics
NPI:1689855348
Name:HASYCHAK, WENDY (LPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:HASYCHAK
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 1:7230 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3053
Mailing Address - Country:US
Mailing Address - Phone:571-248-0757
Mailing Address - Fax:571-248-0758
Practice Address - Street 1:7230 HERITAGE VILLAGE PLZ
Practice Address - Street 2:SUITE 201
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3053
Practice Address - Country:US
Practice Address - Phone:571-248-0757
Practice Address - Fax:571-248-0758
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health