MEDICARE: JOHN KEVIN HEINECKE LCPC

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	101YM0800X	Mental Health Counselor	LC15592	MD

General Provider Information

NPI Number	:	1528910700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN KEVIN HEINECKE LCPC

Provider Business Mailing Address
First Line	:	2012 BRANDY DR
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-3166
Country	:	US
Telephone Number	:	443-313-7251
Fax Number	:	--

Provider Business Practice Location Address
First Line	:	2012 BRANDY DR
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-3166
Country	:	US
Telephone Number	:	910-551-5494
Fax Number	:	--

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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