Healthcare Provider Details

I. General information

NPI: 1295267805
Provider Name (Legal Business Name): ELIZABETH HEFFNER M.ED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH S WIEGAND M.ED

II. Dates (important events)

Enumeration Date: 04/02/2017
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 PENN AVE UNIT 6067
WYOMISSING PA
19610-4813
US

IV. Provider business mailing address

1021 PENN AVE UNIT 6067
WYOMISSING PA
19610-4813
US

V. Phone/Fax

Practice location:
  • Phone: 484-207-6754
  • Fax: 484-538-2992
Mailing address:
  • Phone: 484-207-6754
  • Fax: 484-538-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009500
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: