MEDICARE: LOUIS HEIT MFT, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS16404	CA
2	106H00000X	Marriage & Family Therapist	MFC27844	CA

General Provider Information

NPI Number	:	1184659914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS HEIT MFT, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 235131
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92023-5131
Country	:	US
Telephone Number	:	760-613-9136
Fax Number	:	760-942-7236

Provider Business Practice Location Address
First Line	:	2945 HARDING ST
Second Line	:	STE. 110
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1818
Country	:	US
Telephone Number	:	760-613-9136
Fax Number	:	760-942-7236

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/01/2013

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