Provider Demographics
NPI:1366128092
Name:HECK, JUSTIN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:HECK
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:IN
Mailing Address - Zip Code:47635-1241
Mailing Address - Country:US
Mailing Address - Phone:812-649-9168
Mailing Address - Fax:
Practice Address - Street 1:818 MADISON ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:IN
Practice Address - Zip Code:47635-1241
Practice Address - Country:US
Practice Address - Phone:812-649-9168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker