Provider Demographics
NPI:1013349190
Name:HEIM, VANESSA G (LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:G
Last Name:HEIM
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 1:12011 GOVERNMENT CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22035-1100
Mailing Address - Country:US
Mailing Address - Phone:703-533-5439
Mailing Address - Fax:703-538-7442
Practice Address - Street 1:7611 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE 200E
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2611
Practice Address - Country:US
Practice Address - Phone:703-533-5439
Practice Address - Fax:703-538-7442
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005425101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor