Provider Demographics
NPI:1821213380
Name:HECKER, JEFFREY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:E
Last Name:HECKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-3665
Mailing Address - Country:US
Mailing Address - Phone:207-944-5234
Mailing Address - Fax:207-581-6128
Practice Address - Street 1:69 MAIN ST
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-4002
Practice Address - Country:US
Practice Address - Phone:207-944-5234
Practice Address - Fax:207-581-2033
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME605103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME22937481AMedicaid
ME0033553OtherANTHEM
ME0033553OtherANTHEM