Provider Demographics
NPI:1730802299
Name:HEARD, TESIA SHIRLYNN (LCSW)
Entity type:Individual
Prefix:
First Name:TESIA
Middle Name:SHIRLYNN
Last Name:HEARD
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 1:739 THIMBLE SHOALS BLVD BLDG 704
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3562
Mailing Address - Country:US
Mailing Address - Phone:757-272-6330
Mailing Address - Fax:757-765-7709
Practice Address - Street 1:739 THIMBLE SHOALS BLVD BLDG 704
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3562
Practice Address - Country:US
Practice Address - Phone:757-272-6330
Practice Address - Fax:757-765-7709
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040142751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical