Provider Demographics
NPI:1366820227
Name:HEATON, LEON (MA, RTC)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:HEATON
Suffix:
Gender:M
Credentials:MA, RTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 MCCAUSEY RDG
Mailing Address - Street 2:
Mailing Address - City:FRENCHBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40322-8336
Mailing Address - Country:US
Mailing Address - Phone:606-359-1422
Mailing Address - Fax:
Practice Address - Street 1:875 MCCAUSEY RDG
Practice Address - Street 2:
Practice Address - City:FRENCHBURG
Practice Address - State:KY
Practice Address - Zip Code:40322-8336
Practice Address - Country:US
Practice Address - Phone:606-359-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)