Healthcare Provider Details

I. General information

NPI: 1467683789
Provider Name (Legal Business Name): JOSEPH HEGGINS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 07/31/2021
Certification Date: 07/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 WINTER MOUNTAIN LN
SPRING TX
77379-8580
US

IV. Provider business mailing address

6046 FM 2920 RD # 722
SPRING TX
77379-2542
US

V. Phone/Fax

Practice location:
  • Phone: 410-926-7505
  • Fax:
Mailing address:
  • Phone: 410-926-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72673
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: