Provider Demographics
NPI:1477386720
Name:HEIN, THOMAS JEFFREY (LPC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JEFFREY
Last Name:HEIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E GURLEY ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3823
Mailing Address - Country:US
Mailing Address - Phone:928-445-5400
Mailing Address - Fax:
Practice Address - Street 1:1800 N WILLIAMSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-5297
Practice Address - Country:US
Practice Address - Phone:928-717-3253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-23292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional