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NPI Code Detail

MEDICARE: BRENDA EMILY HEENAN LPC

MEDICARE: BRENDA EMILY HEENAN LPC
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
1101YP2500XProfessional Counselor6401015562MI

General Provider Information

NPI Number : 1265935779
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA EMILY HEENAN LPC
Provider Business Mailing Address
First Line : 1386 ADAMS ST
Second Line :
City : DANSVILLE
State : MI
Zip : 48819-9696
Country : US
Telephone Number : 517-331-3142
Fax Number :
Provider Business Practice Location Address
First Line : 311 HARRISON ST
Second Line :
City : GRAND LEDGE
State : MI
Zip : 48837-1577
Country : US
Telephone Number : 517-338-3090
Fax Number : 517-338-3090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2018
Last Update Date : 10/28/2024

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Directions to “ BRENDA EMILY HEENAN LPC” Practice Location

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