Elizabeth C Heagle, LMHC

Individual provider Active NPI Mental Health Counselor · Scotia, NY

NPI 1780937490 · NPPES record last updated Oct 18, 2012

Key facts

NPI
1780937490
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
001916-1 (NY)
Practice address
409 Vley Rd
Scotia, NY 12302-2607
Phone
(518) 366-0133
NPI assigned
Oct 18, 2012
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

LicenseStateTypeSpecialty
001916-1NYMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001916-1 NY Yes

Addresses

Primary practice location

409 Vley Rd
Scotia, NY 12302-2607

Mailing address

409 Vley Rd
Scotia, NY 12302-2607
Phone (518) 366-0133

Other names

  • Elizabeth C Heagle Former name

Other providers in Scotia, NY

All providers in Scotia, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.