Provider Demographics
NPI:1750893772
Name:HANLEY, HEATHER (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HANLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 GREENBRIAR DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8769
Mailing Address - Country:US
Mailing Address - Phone:908-448-6370
Mailing Address - Fax:
Practice Address - Street 1:342 GREENBRIAR DR UNIT 3
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8769
Practice Address - Country:US
Practice Address - Phone:908-448-6370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ822741101YS0200X
NJ37PC00587100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool