Provider Demographics
NPI:1841272267
Name:HEAVEY, JAMIE (LPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HEAVEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:381 CASA LINDA PLZ
Mailing Address - Street 2:SUITE 170
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3423
Mailing Address - Country:US
Mailing Address - Phone:214-660-0987
Mailing Address - Fax:214-660-0137
Practice Address - Street 1:718 N BUCKNER BLVD
Practice Address - Street 2:SUITE #336
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-2700
Practice Address - Country:US
Practice Address - Phone:214-660-0987
Practice Address - Fax:214-660-0137
Is Sole Proprietor?:No
Enumeration Date:2005-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX19369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7068LCOtherBLUE CROSS BLUE SHIELD