Provider Demographics
NPI:1962173112
Name:HECK, CHARLENE MULLINS (MFT)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:MULLINS
Last Name:HECK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 BARKLEY LANDING DR APT 7
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5292
Mailing Address - Country:US
Mailing Address - Phone:423-353-3964
Mailing Address - Fax:
Practice Address - Street 1:836 W 1ST NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4548
Practice Address - Country:US
Practice Address - Phone:423-616-0213
Practice Address - Fax:865-381-0521
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1819106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty