Provider Demographics
NPI:1801492129
Name:HECKEROTH, KRISTEN (MS, CPRP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HECKEROTH
Suffix:
Gender:F
Credentials:MS, CPRP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:GERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18 VILLAGE OF STONEY RUN APT I
Mailing Address - Street 2:
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-2118
Mailing Address - Country:US
Mailing Address - Phone:908-910-3994
Mailing Address - Fax:
Practice Address - Street 1:770 WOODLANE RD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3804
Practice Address - Country:US
Practice Address - Phone:609-267-5928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health