Provider Demographics
NPI:1194421263
Name:HENEGHAN, ANNALEE HELEN (LCSW)
Entity type:Individual
Prefix:
First Name:ANNALEE
Middle Name:HELEN
Last Name:HENEGHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 W FRANKLIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1503
Mailing Address - Country:US
Mailing Address - Phone:443-690-9618
Mailing Address - Fax:
Practice Address - Street 1:4914 FITZHUGH AVE STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3534
Practice Address - Country:US
Practice Address - Phone:804-223-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040148321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical