Provider Demographics
NPI:1740800341
Name:HECKROTE, ROBERT JAMES (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:HECKROTE
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 1:1057 LOCKARD RD
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-7936
Mailing Address - Country:US
Mailing Address - Phone:570-394-3380
Mailing Address - Fax:
Practice Address - Street 1:1057 LOCKARD RD
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-7936
Practice Address - Country:US
Practice Address - Phone:570-394-3380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC12311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional