Provider Demographics
NPI:1245439900
Name:HEAVEY, CHRISTOPHER LAWRENCE (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LAWRENCE
Last Name:HEAVEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4505 MARYLAND PKWY
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY BOX 455030
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89154-5030
Mailing Address - Country:US
Mailing Address - Phone:702-895-0186
Mailing Address - Fax:702-895-0240
Practice Address - Street 1:4505 S MARYLAND PKWY
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY BOX 455030
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89154-9900
Practice Address - Country:US
Practice Address - Phone:702-895-0186
Practice Address - Fax:702-895-0240
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPY0367103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist