Provider Demographics
NPI:1154552552
Name:HEINTZ, JAMES E II (LCPC, LADC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:HEINTZ
Suffix:II
Gender:M
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 PARK RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3142
Mailing Address - Country:US
Mailing Address - Phone:207-807-9210
Mailing Address - Fax:
Practice Address - Street 1:110 AUBURN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2128
Practice Address - Country:US
Practice Address - Phone:207-807-9210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4379101YA0400X
MECC3560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)