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General NPI Number Information
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NPI Number | 1801191630
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Entity Type | Organization
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Legal Business Name | HEITT CLINICAL AND CORPORATE CONSULTING, LLC
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 8 RESERVOIR CIR STE 105
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City | PIKESVILLE
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State | MD
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Zip | 21208-6362
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Country | US
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Telephone | 410-580-9047
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Fax | 410-580-9046
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Provider Business Mailing Address
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Address Line | 8 RESERVOIR CIR STE 105
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City | PIKESVILLE
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State | MD
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Zip | 21208-6362
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Country | US
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Telephone | 410-580-9047
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Fax | 410-580-9046
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL HEITT
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Credential | PSYD
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Telephone | 410-580-9047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 3448
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License Number State | MD
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