Provider Demographics
NPI:1770155004
Name:VANDEN HEUVEL, LORNA THERESE (LCAS, LCSWA, CSI)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:THERESE
Last Name:VANDEN HEUVEL
Suffix:
Gender:F
Credentials:LCAS, LCSWA, CSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 RETAMA RUN
Mailing Address - Street 2:
Mailing Address - City:NEW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27562-9345
Mailing Address - Country:US
Mailing Address - Phone:919-523-7881
Mailing Address - Fax:
Practice Address - Street 1:3140 RETAMA RUN
Practice Address - Street 2:
Practice Address - City:NEW HILL
Practice Address - State:NC
Practice Address - Zip Code:27562-9345
Practice Address - Country:US
Practice Address - Phone:919-523-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0161231041C0700X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical