Healthcare Provider Details

I. General information

NPI: 1811122609
Provider Name (Legal Business Name): THADDEUS HEFFNER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 RIVERSIDE DR STE. 107
FRANKLIN TN
37064-8984
US

IV. Provider business mailing address

PO BOX 317
FRANKLIN TN
37065-0317
US

V. Phone/Fax

Practice location:
  • Phone: 615-472-1210
  • Fax: 615-465-8495
Mailing address:
  • Phone: 615-472-1210
  • Fax: 615-465-8495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number822
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: