Provider Demographics
NPI:1124745385
Name:HEFFLER-AMT, LAUREN (MED, LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HEFFLER-AMT
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SCARLET OAK DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2420
Mailing Address - Country:US
Mailing Address - Phone:610-209-7562
Mailing Address - Fax:
Practice Address - Street 1:15 SCARLET OAK DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2420
Practice Address - Country:US
Practice Address - Phone:610-209-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PC013918101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor