Provider Demographics
NPI:1356968655
Name:KATHERINE HEINES THERAPY
Entity type:Organization
Organization Name:KATHERINE HEINES THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:WENHAM
Authorized Official - Last Name:HEINES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-370-7403
Mailing Address - Street 1:1303 HAWKINS LN
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4212
Mailing Address - Country:US
Mailing Address - Phone:443-370-7403
Mailing Address - Fax:
Practice Address - Street 1:716 GIDDINGS AVE STE 33
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1419
Practice Address - Country:US
Practice Address - Phone:443-370-7403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health