Lucy Carole Heggenstaller, M.S.W., L.C.S.W.

Individual provider Active NPI Clinical Social Worker · Loganton, PA

NPI 1487734851 · NPPES record last updated Dec 17, 2019

Key facts

NPI
1487734851
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CW013497 (PA)
Practice address
2367 E Winter Rd
Loganton, PA 17747
Phone
(570) 295-9469
Fax
(570) 725-2327
NPI assigned
Oct 17, 2006
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)
Yes

State licenses

LicenseStateTypeSpecialty
CW013497PAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CW013497 PA
Clinical Social Worker 1041C0700X CW013497 PA Yes

Addresses

Primary practice location

2367 E Winter Rd
Loganton, PA 17747

Mailing address

2377 E Winter Rd
Loganton, PA 17747-9341
Phone (570) 295-9469

Other practice location 1

1012 Washington Blvd Ste 2
Williamsport, PA 17701-3679
Phone (570) 295-9469

Other identifiers

IdentifierTypeStateIssuer
1487734851OtherPAHIGHMARK BLUE SHIELD
02096301OtherPACAPITAL BLUE CROSS

Other providers in Loganton, PA

All providers in Loganton, PA · Clinical Social Worker in Pennsylvania

Sources for this page

Verify at the official NPI Registry.