Provider Demographics
NPI:1801191630
Name:HEITT CLINICAL AND CORPORATE CONSULTING, LLC
Entity Type:Organization
Organization Name:HEITT CLINICAL AND CORPORATE CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEITT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-580-9047
Mailing Address - Street 1:8 RESERVOIR CIR STE 105
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6362
Mailing Address - Country:US
Mailing Address - Phone:410-580-9047
Mailing Address - Fax:410-580-9046
Practice Address - Street 1:8 RESERVOIR CIR STE 105
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6362
Practice Address - Country:US
Practice Address - Phone:410-580-9047
Practice Address - Fax:410-580-9046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANDRA HAWKINS-HEITT, PSYD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3448261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health