Healthcare Provider Details

I. General information

NPI: 1700068806
Provider Name (Legal Business Name): JAMES STEVEN HEYMEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 HUDSON HILLS RD
PITTSBORO NC
27312-9339
US

IV. Provider business mailing address

135 HUDSON HILLS RD
PITTSBORO NC
27312-9339
US

V. Phone/Fax

Practice location:
  • Phone: 919-548-6002
  • Fax:
Mailing address:
  • Phone: 919-548-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2314
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: