Provider Demographics
NPI:1649799834
Name:HEEKIN, NICOLA A (LPCC)
Entity type:Individual
Prefix:MRS
First Name:NICOLA
Middle Name:A
Last Name:HEEKIN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:NIKKI
Other - Middle Name:A
Other - Last Name:HEEKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:126 HEADY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3916
Mailing Address - Country:US
Mailing Address - Phone:502-592-7276
Mailing Address - Fax:
Practice Address - Street 1:126 HEADY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3916
Practice Address - Country:US
Practice Address - Phone:502-592-7276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0501368101Y00000X, 101YM0800X
KY163092101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health