Healthcare Provider Details

I. General information

NPI: 1124745385
Provider Name (Legal Business Name): LAUREN HEFFLER-AMT M.ED., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SCARLET OAK DR
LAFAYETTE HILL PA
19444-2420
US

IV. Provider business mailing address

15 SCARLET OAK DR
LAFAYETTE HILL PA
19444-2420
US

V. Phone/Fax

Practice location:
  • Phone: 610-209-7562
  • Fax:
Mailing address:
  • Phone: 610-209-7562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC013918
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: