Provider Demographics
NPI:1457478448
Name:LYKAS, HEATHER (LMHC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LYKAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:31 JOHN CLARKE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5641
Mailing Address - Country:US
Mailing Address - Phone:401-848-4206
Mailing Address - Fax:
Practice Address - Street 1:687 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2232
Practice Address - Country:US
Practice Address - Phone:800-455-8726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00424101YM0800X
MA5945101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health