Individual provider Active NPI

Kathleen Mary Heffernan, LPC

  • Mental Health Counselor
  • Glendale, AZ
National Provider Identifier
1356461487
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-1748 Issued in AZ
Practice address
18001 N 79TH Ave
B-45
Glendale, AZ 85308-8388
Phone
(602) 770-4188
Fax
(623) 334-6724
NPI assigned
Mar 30, 2007
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-1748 AZ Primary

Addresses

Primary practice location

18001 N 79TH Ave
B-45
Glendale, AZ 85308-8388

Mailing address

2753 E Windrose Dr
Phoenix, AZ 85032-6932
Phone (602) 770-4188

Other identifiers 1

IdentifierTypeStateIssuer
806309MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-1748AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowhead Family Systems LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1356461487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 E WINDROSE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850326932",
            "telephone_number": "602-770-4188",
            "fax_number": "623-334-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE",
            "address_2": "B-45",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088388",
            "telephone_number": "602-770-4188",
            "fax_number": "623-334-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-1748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806309",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.