Provider Demographics
NPI:1700900404
Name:HEARD, IRENE HOSKIN (MA, BS, CAC-R)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:HOSKIN
Last Name:HEARD
Suffix:
Gender:F
Credentials:MA, BS, CAC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24224 W 7 MILE RD APT 51 A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4640
Mailing Address - Country:US
Mailing Address - Phone:313-541-6862
Mailing Address - Fax:
Practice Address - Street 1:1400 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2651
Practice Address - Country:US
Practice Address - Phone:248-547-2223
Practice Address - Fax:248-547-2226
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2-00337OtherCERTIFIED ADDICTIONS COUN