Provider Demographics
NPI:1134746399
Name:THIGPEN, HEATHER NICOLE (MED, LCMHC, NCC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:THIGPEN
Suffix:
Gender:F
Credentials:MED, LCMHC, NCC
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LCMHC, NCC
Mailing Address - Street 1:8651B STEPHENS CHURCH RD APT 305
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8034
Mailing Address - Country:US
Mailing Address - Phone:919-398-5067
Mailing Address - Fax:
Practice Address - Street 1:8651B STEPHENS CHURCH RD APT 305
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8034
Practice Address - Country:US
Practice Address - Phone:919-398-5067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health