Provider Demographics
NPI:1922435437
Name:HEIST, MELANIE JENNIFER (MS,BSL,LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:JENNIFER
Last Name:HEIST
Suffix:
Gender:F
Credentials:MS,BSL,LPC
Other - Prefix:MISS
Other - First Name:MELANIE
Other - Middle Name:JENNIFER
Other - Last Name:DRESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AA,BA
Mailing Address - Street 1:4370 FIELDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9759
Mailing Address - Country:US
Mailing Address - Phone:484-347-9821
Mailing Address - Fax:
Practice Address - Street 1:4370 FIELDSTONE CT
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9759
Practice Address - Country:US
Practice Address - Phone:484-347-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-28
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007032101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional