Provider Demographics
NPI:1669440095
Name:LAFAZIA HEIMBECKER, JOYCE L (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:L
Last Name:LAFAZIA HEIMBECKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 NEW LONDON AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3035
Mailing Address - Country:US
Mailing Address - Phone:401-463-5778
Mailing Address - Fax:401-463-3582
Practice Address - Street 1:1090 NEW LONDON AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-3035
Practice Address - Country:US
Practice Address - Phone:401-463-5778
Practice Address - Fax:401-463-3582
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00056101YM0800X
RICDP00208101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICOP00208OtherCHEMICAL DEPENDANCY PROF
RIMHC00056OtherMENTAL HEALTH COUNSELOR