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General NPI Number Information
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NPI Number | 1528910700
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Entity Type | Individual
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Provider Name | JOHN KEVIN HEINECKE LCPC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 2012 BRANDY DR
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City | FOREST HILL
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State | MD
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Zip | 21050-3166
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Country | US
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Telephone | 910-551-5494
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Fax | --
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Provider Business Mailing Address
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Address Line | 2012 BRANDY DR
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City | FOREST HILL
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State | MD
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Zip | 21050-3166
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Country | US
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Telephone | 443-313-7251
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC15592
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License Number State | MD
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