MEDICARE: HEEREN FAMILY THERAPY

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OB81353	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1548317886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEEREN FAMILY THERAPY

Provider Business Mailing Address
First Line	:	12935 S WEST BAY SHORE DR STE 330
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-6291
Country	:	US
Telephone Number	:	231-933-4661
Fax Number	:	231-933-4661

Provider Business Practice Location Address
First Line	:	12935 S WEST BAY SHORE DR STE 330
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-6291
Country	:	US
Telephone Number	:	231-933-4661
Fax Number	:	231-933-4661

Authorized Official
Title or Position	:	PARTNER
Name	:	MRS. ALLISON BRANTMAN HEEREN
Credential	:	LMSW
Telephone Number	:	231-933-4661

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	05/13/2019

Similar Medicare Providers

1245341890 — MS. ALLISON B HEEREN MSW
Practice Location Address:

12935 S WEST BAY SHORE DR STE 330
TRAVERSE CITY, MI
49684-6291

Practice Phone: 231-933-4661
Practice Fax: 231-346-6032

1548317985 — MR. ROY CHARLES HEEREN LMSW, ACSW
Practice Location Address:

12935 S WEST BAY SHORE DR STE 330
TRAVERSE CITY, MI
49684-6291

Practice Phone: 231-933-4661
Practice Fax: 231-933-4661

1891657755 — LAYNE ODAY MEYER
Practice Location Address:

2740 N HARBOR CITY BLVD
MELBOURNE, FL
32935-6291

Practice Phone: 321-622-6884
Practice Fax:

1003232745 — ALYSSA HEYER BCBA
Practice Location Address:

2740 N HARBOR CITY BLVD
MELBOURNE, FL
32935-6291

Practice Phone: 321-622-6884
Practice Fax: 321-622-6842

1114415718 — DIANE JANEAN LUCAS
Practice Location Address:

3016 NW 41ST ST APT 27
OKLAHOMA CITY, OK
73112-6291

Practice Phone: 405-968-5074
Practice Fax:

1457829848 — LYZA M GALLOZA BCBA
Practice Location Address:

2740 N HARBOR CITY BLVD
MELBOURNE, FL
32935-6291

Practice Phone: 321-622-6884
Practice Fax:

Directions to “HEEREN FAMILY THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.