Theis, Kelly Heiges

Theis, Kelly Heiges is an sole proprietor health care provider with primary practice located at 8381 Old Courthouse Road Suite 330, Vienna VA 22182-1670. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Theis, Kelly Heiges can be contacted via phone (703) 938-9090.

Contact Information

Primary practice address
8381 Old Courthouse Road Suite 330 Vienna VA 22182-1670
Phone: (703) 938-9090
Fax: (703) 938-9091
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 081003318 Virginia

Profile Details

NPI number 1811093149
LBN Legal business name Theis, Kelly Heiges
Credentials PH.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Sep 1st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811093149 NPPES
Virginia Other 293937 AMERIGROUP
Virginia Other 715692000 AMERIGROUP
Virginia Other 541598045 AMERIGROUP
Virginia Other 89130026 AMERIGROUP
Virginia MEDICAID 010099072 AMERIGROUP
Virginia Other 7751599 AMERIGROUP
Virginia Other 139309 AMERIGROUP
Virginia Other 541598045 AMERIGROUP

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