Carol Sue Heavin, LAC, TA
Individual provider Active NPI Mental Health Counselor · Mabelvale, AR
NPI 1154964872 · NPPES record last updated Oct 25, 2019
Key facts
- NPI
- 1154964872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- A1707234 (AR)
- Practice address
- 10500 Woodman St
Mabelvale, AR 72103-1789 - Phone
- (501) 247-1456
- NPI assigned
- Oct 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1707234 | AR | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A1707234 | AR | Yes |
Addresses
Primary practice location
10500 Woodman St
Mabelvale, AR 72103-1789
Mailing address
11201 Heinke Rd
Mabelvale, AR 72103-2048
Phone (501) 455-5793
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | carol.heavin@counselingsecure.com |
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All providers in Mabelvale, AR · Mental Health Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.