Provider Demographics
NPI:1043970809
Name:KINSEY, HEATHER GOLDNER (LMFT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GOLDNER
Last Name:KINSEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 2ND STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1807
Mailing Address - Country:US
Mailing Address - Phone:267-241-9890
Mailing Address - Fax:
Practice Address - Street 1:110 S YORK RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-3327
Practice Address - Country:US
Practice Address - Phone:267-241-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001118106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist