Provider Demographics
NPI:1790844231
Name:HEIM, EMILY S (MA, MSW, LPC, LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:S
Last Name:HEIM
Suffix:
Gender:F
Credentials:MA, MSW, LPC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 ASHWOOD DR STE 1201
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-4982
Mailing Address - Country:US
Mailing Address - Phone:724-884-0466
Mailing Address - Fax:724-649-0039
Practice Address - Street 1:1200 ASHWOOD DR STE 1201
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-4982
Practice Address - Country:US
Practice Address - Phone:724-884-0466
Practice Address - Fax:724-649-0039
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC 1606101YP2500X
PACW0133551041C0700X
PAPC006403101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395502OtherMHN
PA093655OtherTRICARE
PA120060Medicaid
PA203054OtherUPMC
PA368680OtherBC/BS HIGHMARK
PA2668179OtherUNITED HEALTHCARE MPIN
PA62474378OtherMULTIPLAN
PA11613707OtherCIGNA
PA5448648OtherAETNA
PA180834Medicare PIN