Heather Lynn Wardlaw, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC012213 Issued in PA

Practice address

201 York Rd Ste 1-564
Jenkintown, PA 19046-3200

Phone

(267) 419-7846

Fax

(215) 372-0124

NPI assigned

Aug 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Life'S Metamorphosis LLC

  • Community/Behavioral Health Agency
  • Jenkintown, PA
  • NPI 1114602570
  NPD Authorized official

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1265106926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7914 WALTHAM RD",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121713",
            "telephone_number": "267-419-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 YORK RD STE 1-564",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463200",
            "telephone_number": "267-419-7846",
            "fax_number": "215-372-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDLAW",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taneisha Walker
• Margaret Mary Walsh-Foden, LCSW
• Justin C. Walters, MS
• James Wang
• Susana Mary Ward, CRNP
• Krizia Wearing
• Matthew Weiner
• Martin Weisberg, MD
• Don M Weiss, D.C.
• Michael Alan Weiss, D.D.S.

• Professional Counselor in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.