Healthcare Provider Details

I. General information

NPI: 1639622327
Provider Name (Legal Business Name): JOSHUA HEYING LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 12/07/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 E NC HIGHWAY 54 STE 320
DURHAM NC
27713-2490
US

IV. Provider business mailing address

10 CREEKS EDGE CT
DURHAM NC
27713-8591
US

V. Phone/Fax

Practice location:
  • Phone: 919-907-0482
  • Fax:
Mailing address:
  • Phone: 301-535-3804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP010679
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC011724
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: