Justin Michael Heilenbach, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0074343 Issued in VT

Practice address

25 Wentworth Dr
Williston, VT 05495-9733

Phone

(802) 878-4990

Fax

(802) 878-1477

NPI assigned

Jan 16, 2008

Last updated

Jan 20, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• New England Counseling and Trauma Associate

  • Mental Health Counselor
  • Williston, VT
  • NPI 1679882351
  NPD (past)

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1972789345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 NE RANDALL AVE",
            "address_2": "APT 303",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322384",
            "telephone_number": "503-890-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WENTWORTH DR",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959733",
            "telephone_number": "802-878-4990",
            "fax_number": "802-878-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILENBACH",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0074343",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4064",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Mahon Hastings, MD
• Johanna Hauser, PA
• Healing Connection and Wellness LLC
• Healthdirect Institutional Pharmacy Services, Inc. (Healthdirect Institutional Pharmacy Services, Inc. #69)
• Alyse Heffelfinger, BCABA
• Hella S Douglas PLLC
• Erik Westbrook Hemmett, DC
• Caitlin Taylor Henck, BCBA
• Angelina Herridge, OT
• Christiane Herskowitz, P.T.

• Clinical Social Worker in Williston, VT
• Providers in Williston, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.