Provider Demographics
NPI:1699131185
Name:JANET HEURING
Entity type:Organization
Organization Name:JANET HEURING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST, ADDICTION SP
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HEURING
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS, LPA, HSP-PA
Authorized Official - Phone:919-749-5724
Mailing Address - Street 1:4501 NEW BERN AVE
Mailing Address - Street 2:SUITE 130-183
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1549
Mailing Address - Country:US
Mailing Address - Phone:919-749-5724
Mailing Address - Fax:
Practice Address - Street 1:133 KEYBRIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5915
Practice Address - Country:US
Practice Address - Phone:919-749-5724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPA-4887251S00000X
NCLCAS-21893251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health