Provider Demographics
NPI:1659605228
Name:WILLINGHAM, HEATH ALAN (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:HEATH
Middle Name:ALAN
Last Name:WILLINGHAM
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1276 TAYLOR CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-2126
Mailing Address - Country:US
Mailing Address - Phone:334-444-9938
Mailing Address - Fax:
Practice Address - Street 1:310 24TH ST
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6248
Practice Address - Country:US
Practice Address - Phone:334-444-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional