Provider Demographics
NPI:1295826444
Name:HEFFERNAN, JUNE
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:HEFFERNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 NEW BRITAIN RD
Mailing Address - Street 2:UNIT # 132
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-1363
Mailing Address - Country:US
Mailing Address - Phone:860-828-3868
Mailing Address - Fax:
Practice Address - Street 1:114 BOSTON POST RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2043
Practice Address - Country:US
Practice Address - Phone:203-931-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor