Provider Demographics
NPI:1366537672
Name:HECK, ANDREW LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LEE
Last Name:HECK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 PARK WEST CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-5552
Mailing Address - Country:US
Mailing Address - Phone:804-993-4304
Mailing Address - Fax:855-998-4376
Practice Address - Street 1:1 PARK WEST CIR STE 102
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-5552
Practice Address - Country:US
Practice Address - Phone:804-993-4304
Practice Address - Fax:855-998-4376
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0810002923103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0810002923OtherVA PSYCHOLOGY LICENSE
VA7712260Medicaid
VA7712260Medicaid