Provider Demographics
NPI:1316305899
Name:HATHORNE, TYKESIA JOYCELYN (LPC)
Entity type:Individual
Prefix:MRS
First Name:TYKESIA
Middle Name:JOYCELYN
Last Name:HATHORNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TYKESIA
Other - Middle Name:JOYCELYN
Other - Last Name:PRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TYKESIA PRIER, LPC
Mailing Address - Street 1:528 TRIADELPHIA WAY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-3406
Mailing Address - Country:US
Mailing Address - Phone:318-305-6485
Mailing Address - Fax:
Practice Address - Street 1:6300 STEVENSON AVE STE B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3554
Practice Address - Country:US
Practice Address - Phone:703-935-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor