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General NPI Number Information
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NPI Number | 1598125114
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Entity Type | Individual
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Provider Name | JANELLE HEDDINGS PHD
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Gender | Female
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 930 CHESTNUT RIDGE RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-2807
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Country | US
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Telephone | 304-598-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 GILLHAM RD PROVIDER ENROLLMENT
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City | KANSAS CITY
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State | MO
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Zip | 64108-4619
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Country | US
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Telephone | 816-701-5200
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Fax | 816-302-9939
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 2016032355
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1291
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License Number State | WV
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