Provider Demographics
NPI:1316201627
Name:HECKMAN, IRENE BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:BETH
Last Name:HECKMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:BETH
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:27 N BINGAMAN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-1440
Mailing Address - Country:US
Mailing Address - Phone:484-651-7511
Mailing Address - Fax:
Practice Address - Street 1:1235 PENN AVE
Practice Address - Street 2:SUITE 205-206
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2100
Practice Address - Country:US
Practice Address - Phone:610-374-4963
Practice Address - Fax:610-378-5403
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129149104100000X
PACW0191691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker