Provider Demographics
NPI:1174670558
Name:HEANY, BRUCE R (DMIN,LPC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:R
Last Name:HEANY
Suffix:
Gender:M
Credentials:DMIN,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11674 HURON STREET #200
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234
Mailing Address - Country:US
Mailing Address - Phone:303-212-2164
Mailing Address - Fax:303-428-7303
Practice Address - Street 1:11674 HURON STREET #200
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234
Practice Address - Country:US
Practice Address - Phone:303-212-2164
Practice Address - Fax:303-428-7303
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1408101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral