Paul Hedg-Peth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008416 Issued in VA

Practice address

7611 Coppermine Dr
Manassas, VA 20109-2668

Phone

(703) 496-7804

NPI assigned

Jan 30, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1285265017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 AVEMORE SQUARE PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117228",
            "telephone_number": "703-496-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 COPPERMINE DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092668",
            "telephone_number": "703-496-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDG-PETH",
        "first_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• H. Keith Hellems Jr., M.D.

• Clinical Social Worker in Manassas, VA
• Providers in Manassas, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.