Provider Demographics
NPI:1578791034
Name:HEILER, JAMES TIMOTHY
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:TIMOTHY
Last Name:HEILER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 AIRLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-2912
Mailing Address - Country:US
Mailing Address - Phone:757-488-9382
Mailing Address - Fax:757-488-9564
Practice Address - Street 1:2404 AIRLINE BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-2912
Practice Address - Country:US
Practice Address - Phone:757-488-9382
Practice Address - Fax:757-488-9564
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor