Provider Demographics
NPI:1790870517
Name:HEARD, KATHERINE COLLINS (LCPC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:COLLINS
Last Name:HEARD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-4442
Mailing Address - Country:US
Mailing Address - Phone:207-691-2742
Mailing Address - Fax:
Practice Address - Street 1:21 ELM ST FL 3
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1902
Practice Address - Country:US
Practice Address - Phone:207-691-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3612101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432289299Medicaid