Individual provider Active NPI

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

  • Clinical Social Worker
  • Loganton, PA
National Provider Identifier
1487734851
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW013497 Issued in PA
Practice address
2367 E Winter Rd
Loganton, PA 17747
Phone
(570) 295-9469
Fax
(570) 725-2327
NPI assigned
Oct 17, 2006
Last updated
Dec 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 2

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

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

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW013497PAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1487734851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 E WINTER RD",
            "city": "LOGANTON",
            "state": "PA",
            "postal_code": "177479341",
            "telephone_number": "570-295-9469",
            "fax_number": "570-725-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 E WINTER RD",
            "city": "LOGANTON",
            "state": "PA",
            "postal_code": "17747",
            "telephone_number": "570-295-9469",
            "fax_number": "570-725-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 Washington Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177013679",
            "country_code": "US",
            "telephone_number": "570-295-9469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEGGENSTALLER",
        "first_name": "LUCY",
        "middle_name": "CAROLE",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW013497",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.