Provider Demographics
NPI:1881082832
Name:HEPNER, AMY TUTHILL (LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:TUTHILL
Last Name:HEPNER
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:KATHRYN
Other - Last Name:TUTHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:6330 NEWTOWN RD
Mailing Address - Street 2:SUITE #300
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4802
Mailing Address - Country:US
Mailing Address - Phone:757-466-3336
Mailing Address - Fax:757-455-5750
Practice Address - Street 1:923 FIRST COLONIAL RD
Practice Address - Street 2:SUITE #1820
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3182
Practice Address - Country:US
Practice Address - Phone:757-422-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005930101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1801906144Medicaid