Provider Demographics
NPI:1548665409
Name:HEDINGER, TODD (PHD, LPC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:HEDINGER
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 W SPRINGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:VA
Mailing Address - Zip Code:22815
Mailing Address - Country:US
Mailing Address - Phone:540-896-7687
Mailing Address - Fax:540-896-7687
Practice Address - Street 1:133 W SPRINGBROOK RD
Practice Address - Street 2:
Practice Address - City:BROADWAY
Practice Address - State:VA
Practice Address - Zip Code:22815
Practice Address - Country:US
Practice Address - Phone:540-435-4632
Practice Address - Fax:540-896-7687
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005713101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA601052323Medicaid
VA0701005713OtherLICENSED PROFESSIONAL COUNSELOR