Alexis G Heitman, LMHC, LCDP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC00431 Issued in RI

Practice address

4705A Old Post Rd
Charlestown, RI 02813-1819

Phone

(401) 364-7705

Fax

(401) 364-9104

NPI assigned

Oct 4, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 17, 2024 through Feb 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932
  NPD (past)
• South Shore Center Inc

  • Group Psychotherapy Psychologist
  • Charlestown, RI
  • NPI 1255327391

  Addiction (Substance Use Disorder)

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1134454556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705A OLD POST RD",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028131819",
            "telephone_number": "401-364-7705",
            "fax_number": "401-364-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705A OLD POST RD",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028131819",
            "telephone_number": "401-364-7705",
            "fax_number": "401-364-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITMAN",
        "first_name": "ALEXIS",
        "middle_name": "G",
        "credential": "LMHC, LCDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-04",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00431",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP00470",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSRI",
            "identifier": "1134454556",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "461277",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AH78980",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3039767",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brendan C. Gouin, D.M.D.
• Bruce D Gouin, D.M.D.
• Teresa W Greer, MD
• Jessica Harrison
• Sarah Hauser, LCSW
• Kathleen Hendershot, RN
• Joyce Ellen Hickey, RN
• Wendy E Holland, ARNP
• Diane Houston, LICSW
• Janice Lynn Hovey, RN

• Mental Health Counselor in Charlestown, RI
• Providers in Charlestown, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.