Provider Demographics
NPI:1417041443
Name:KILROY, HEATHER LEE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LEE
Last Name:KILROY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:STEPEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3580 INDIAN QUEEN LANE
Mailing Address - Street 2:
Mailing Address - City:PHILA.
Mailing Address - State:PA
Mailing Address - Zip Code:19129
Mailing Address - Country:US
Mailing Address - Phone:267-975-4426
Mailing Address - Fax:267-331-6822
Practice Address - Street 1:3580 INDIAN QUEEN LANE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129
Practice Address - Country:US
Practice Address - Phone:267-975-4426
Practice Address - Fax:267-331-6822
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002345101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor