Provider Demographics
NPI:1275697369
Name:HEGER, JOHN GABRIEL (PSYS LLP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GABRIEL
Last Name:HEGER
Suffix:
Gender:M
Credentials:PSYS LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10839 CHARRING CROSS CIR
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9100
Mailing Address - Country:US
Mailing Address - Phone:734-223-3284
Mailing Address - Fax:
Practice Address - Street 1:1308 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2253
Practice Address - Country:US
Practice Address - Phone:734-451-3440
Practice Address - Fax:734-451-8720
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361007168103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist