Provider Demographics
NPI:1215666169
Name:KEEFE, HEATHER (PSYD, LCP)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:KEEFE
Suffix:
Gender:F
Credentials:PSYD, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 W 21ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1539
Mailing Address - Country:US
Mailing Address - Phone:757-319-4650
Mailing Address - Fax:757-644-5065
Practice Address - Street 1:1000 REGENT UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5037
Practice Address - Country:US
Practice Address - Phone:757-319-4650
Practice Address - Fax:757-644-5065
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA081007847103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical