Provider Demographics
NPI:1861866709
Name:HEIKKINEN, ROSE (LCPC-C)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:HEIKKINEN
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:MAHANOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 MOODY ST
Mailing Address - Street 2:ATTN: SWEETSER
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1536
Mailing Address - Country:US
Mailing Address - Phone:800-434-3000
Mailing Address - Fax:
Practice Address - Street 1:50 MOODY ST
Practice Address - Street 2:ATTN: SWEETSER
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1536
Practice Address - Country:US
Practice Address - Phone:800-434-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4605101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional