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General NPI Number Information
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NPI Number | 1467983304
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Entity Type | Individual
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Provider Name | JENNIFER E HEATON LCPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 3750 UNIVERSITY BLVD W STE 200
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City | KENSINGTON
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State | MD
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Zip | 20895-2136
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Country | US
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Telephone | 301-338-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 UNIVERSITY BLVD W SUITE 200
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City | KENSINGTON
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State | MD
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Zip | 20895-4046
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Country | US
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Telephone | 301-639-9847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGP7720
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP7720
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LGP7720
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License Number State | MD
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