Healthcare Provider Details

I. General information

NPI: 1447809363
Provider Name (Legal Business Name): BRIANNA MAE HECKELMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 AVERY WAY
CASTLE ROCK CO
80109-3717
US

IV. Provider business mailing address

1815 AVERY WAY
CASTLE ROCK CO
80109-3717
US

V. Phone/Fax

Practice location:
  • Phone: 760-301-2202
  • Fax:
Mailing address:
  • Phone: 760-301-2202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0021526
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: