MICHAEL HEFFERNAN LICSW LCDP NPI 1588738603

NPI Information

NPI: 1588738603
Provider Name: MICHAEL HEFFERNAN, LICSW, LCDP
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
345 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906
Phone: (401) 421-7900
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Michael Heffernan, LICSW, LCDP is an addiction (substance use disorder) counselor in Providence, RI. Michael Heffernan, LICSW, LCDP NPI is 1588738603. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

345 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906-800
Phone: (401) 421-7900

The enumeration date for this NPI number is 11/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCDP 00193	RHODE ISLAND	Yes
2	1041C0700X	Social Worker	Clinical	ISW 00358	RHODE ISLAND	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	205032	OTHER	RHODE ISLAND	RI BLUECROSS-BLUECHIP
2	23588-4	OTHER	RHODE ISLAND	RI BLUECROSS-BLUESHIELD
3	62-52319	OTHER	RHODE ISLAND	UNITEDBEHAVIORALHEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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