Provider Demographics
NPI:1558428797
Name:HEELY, MARGARET MARY (LMFT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:HEELY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 S FLOYD ST
Mailing Address - Street 2:1
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2722
Mailing Address - Country:US
Mailing Address - Phone:502-424-4665
Mailing Address - Fax:
Practice Address - Street 1:224 BRECKENRIDGE LN
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3859
Practice Address - Country:US
Practice Address - Phone:502-424-4665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000090106H00000X
KY0719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist