Provider Demographics
NPI:1184659914
Name:HEIT, LOUIS (MFT, LCSW)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:HEIT
Suffix:
Gender:M
Credentials:MFT, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 235131
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-5131
Mailing Address - Country:US
Mailing Address - Phone:760-613-9136
Mailing Address - Fax:760-942-7236
Practice Address - Street 1:2945 HARDING ST
Practice Address - Street 2:STE. 110
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1818
Practice Address - Country:US
Practice Address - Phone:760-613-9136
Practice Address - Fax:760-942-7236
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS164041041C0700X
CAMFC27844106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABB843ZMedicare UPIN