Provider Demographics
NPI:1760022008
Name:HEYWARD, KARENA
Entity Type:Individual
Prefix:DR
First Name:KARENA
Middle Name:
Last Name:HEYWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 WISE ST. #4786
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22905-1224
Mailing Address - Country:US
Mailing Address - Phone:804-767-7663
Mailing Address - Fax:
Practice Address - Street 1:55 LAFAYETTE DR
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-3001
Practice Address - Country:US
Practice Address - Phone:804-926-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional