Provider Demographics
NPI:1578202115
Name:HEART CENTERED SERVICES, PLLC
Entity Type:Organization
Organization Name:HEART CENTERED SERVICES, PLLC
Other - Org Name:LORETTA PICKFORD, LPC, NCC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PICKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:231-434-8587
Mailing Address - Street 1:4101 W FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49651-9710
Mailing Address - Country:US
Mailing Address - Phone:231-434-8587
Mailing Address - Fax:844-206-0063
Practice Address - Street 1:4101 W FOREST RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MI
Practice Address - Zip Code:49651-9710
Practice Address - Country:US
Practice Address - Phone:231-434-8587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty