Provider Demographics
NPI:1699074047
Name:MCMILLAN, HEIKE (LPC)
Entity type:Individual
Prefix:MS
First Name:HEIKE
Middle Name:
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 OZORA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8631
Mailing Address - Country:US
Mailing Address - Phone:770-554-2389
Mailing Address - Fax:770-554-2389
Practice Address - Street 1:970 MILSTEAD AVE NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4526
Practice Address - Country:US
Practice Address - Phone:770-860-8549
Practice Address - Fax:866-210-1269
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001966101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional