Healthcare Provider Details

I. General information

NPI: 1659752905
Provider Name (Legal Business Name): JANET HEURING LCAS, LPA, HSP-PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 KEYBRIDGE DR SUITE A
MORRISVILLE NC
27560-5915
US

IV. Provider business mailing address

4501 NEW BERN AVE SUITE 130-183
RALEIGH NC
27610-1549
US

V. Phone/Fax

Practice location:
  • Phone: 919-749-5724
  • Fax: 919-882-1426
Mailing address:
  • Phone: 919-819-5736
  • Fax: 919-882-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-21893
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4887
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: