Provider Demographics
NPI:1124436340
Name:HEGEDUS, KRISZTINA (LCSWA)
Entity type:Individual
Prefix:
First Name:KRISZTINA
Middle Name:
Last Name:HEGEDUS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 COPPERFIELD BLVD NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2433
Mailing Address - Country:US
Mailing Address - Phone:704-721-0000
Mailing Address - Fax:704-973-7835
Practice Address - Street 1:1371 E GARRISON BLVD STE A
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5155
Practice Address - Country:US
Practice Address - Phone:704-833-0154
Practice Address - Fax:704-833-7076
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NCP0113331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker