Provider Demographics
NPI:1386708790
Name:HEARD, GARY HENRY (BA, CADC II)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:HENRY
Last Name:HEARD
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Gender:M
Credentials:BA, CADC II
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Mailing Address - Street 1:1748 COTTAGE ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3020
Mailing Address - Country:US
Mailing Address - Phone:503-585-4982
Mailing Address - Fax:503-361-2688
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:DRUG TREATMENT
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-588-5358
Practice Address - Fax:503-361-2688
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)