Healthcare Provider Details

I. General information

NPI: 1891914297
Provider Name (Legal Business Name): NANCY ELIZABETH BURNS-HEAGNEY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY ELIZABETH JOBIN OT

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 GONDOLA AVE
JAMESTOWN RI
02835-2345
US

IV. Provider business mailing address

395 GONDOLA AVE
JAMESTOWN RI
02835-2345
US

V. Phone/Fax

Practice location:
  • Phone: 401-258-3046
  • Fax:
Mailing address:
  • Phone: 401-258-3046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01371
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0T00272
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: