MEDICARE: DR. HELEN HEEREN PH.D.

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	CW-002640-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	62004820	OTHER	UNITED BEHAVIORAL HEALTH
2	118396	OTHER	MHN
3	225656	OTHER	COMPSYCH
4	6896123002	OTHER	GHI
5	N2757	OTHER	EMPIRE BLUE
6	280100	OTHER	VALUE OPTIONS
7	HE1675569	OTHER	HIGHMARK BLUE
8	2168547	OTHER	CIGNA
9	803467	OTHER	1ST PRIORITY HEALTH

General Provider Information

NPI Number	:	1528066024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN HEEREN PH.D.

Provider Business Mailing Address
First Line	:	523 SARAH ST
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-2118
Country	:	US
Telephone Number	:	570-424-1853
Fax Number	:	570-424-1580

Provider Business Practice Location Address
First Line	:	523 SARAH ST
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-2118
Country	:	US
Telephone Number	:	570-424-1853
Fax Number	:	570-424-1580

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. HELEN HEEREN PH.D.” Practice Location

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