Provider Demographics
NPI:1891914297
Name:BURNS-HEAGNEY, NANCY ELIZABETH (LMHC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:BURNS-HEAGNEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ELIZABETH
Other - Last Name:JOBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:395 GONDOLA AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02835-2345
Mailing Address - Country:US
Mailing Address - Phone:401-258-3046
Mailing Address - Fax:
Practice Address - Street 1:395 GONDOLA AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02835-2345
Practice Address - Country:US
Practice Address - Phone:401-258-3046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI0T00272225X00000X
RIMHC01371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RINB45127Medicaid