Provider Demographics
NPI:1760753834
Name:HEDDEN, MICHAEL R (LMHC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:HEDDEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640041
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34464-0041
Mailing Address - Country:US
Mailing Address - Phone:352-325-3424
Mailing Address - Fax:
Practice Address - Street 1:3971 N LECANTO HWY UNIT 640041
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34464-7704
Practice Address - Country:US
Practice Address - Phone:352-325-3424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-22
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC12686101YP2500X
171400000X
FLMH7794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171400000XOther Service ProvidersHealth & Wellness Coach