Healthcare Provider Details

I. General information

NPI: 1124680277
Provider Name (Legal Business Name): ANN MARIE A HEFFERAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 W PIKE ST
CANONSBURG PA
15317-1188
US

IV. Provider business mailing address

4006 POINTE CT
CANONSBURG PA
15317-3906
US

V. Phone/Fax

Practice location:
  • Phone: 412-491-8703
  • Fax:
Mailing address:
  • Phone: 412-491-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010937
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: