Provider Demographics
NPI:1265195341
Name:HEGGS, VIOLA (LCADC)
Entity type:Individual
Prefix:PROF
First Name:VIOLA
Middle Name:
Last Name:HEGGS
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N WASHINGTON ST APT B
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1536
Mailing Address - Country:US
Mailing Address - Phone:856-434-2490
Mailing Address - Fax:
Practice Address - Street 1:220 N WASHINGTON ST APT B
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1536
Practice Address - Country:US
Practice Address - Phone:856-434-2490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00317400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)