Provider Demographics
NPI:1942652896
Name:HEINEMAN, JAMIE L (LPCC)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:L
Last Name:HEINEMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5554 EUREKA DR STE B
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4208
Mailing Address - Country:US
Mailing Address - Phone:513-857-2098
Mailing Address - Fax:
Practice Address - Street 1:5554 EUREKA DR STE B
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-4208
Practice Address - Country:US
Practice Address - Phone:513-857-2098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-04
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2002044101Y00000X
OHC.1600320101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor