Provider Demographics
NPI:1407474257
Name:HEARD, WILLIAM LAWRENCE (PSYD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LAWRENCE
Last Name:HEARD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1473
Mailing Address - Country:US
Mailing Address - Phone:708-546-8971
Mailing Address - Fax:
Practice Address - Street 1:1269 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1473
Practice Address - Country:US
Practice Address - Phone:708-546-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0700X, 103TH0100X
IN20043390A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service