MICHAEL HEAVEN


Address: 601 Blue Hills Ave, Apt B2, Hartford, CT 06112-1254
Phone: 8602420848

MICHAEL HEAVEN (NPI# 1053859553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053859553
Entity Type Individual
Full Name MICHAEL HEAVEN
Practice Address 601 Blue Hills Ave
Apt B2
Hartford
CT 06112-1254
Practice Telephone 8602420848
Mailing Telephone 8602420848
Enumeration Date 2017-02-03
Last Update Date 2017-02-03
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 601 BLUE HILLS AVE
APT B2
City HARTFORD
State CT
Zip Code 06112-1254

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1194191973 Esther Wint Nurse Practitioner 490 Blue Ave, Hartford, CT 06112 2015-08-17
1194105700 Michelle Russi Physical Therapy Assistant 490 Blue Hill Ave., Hartford, CT 06112 2015-06-09
1366858359 Krysten N Marotta Pharmacist 1290 Albany Ave, Hartford, CT 06112 2014-07-10
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164064044 Shawn Tyson Counselor 330 Main St Fl 1, Hartford, CT 06106-1851 2019-10-12
1114401510 Roberto Carlos Vargas Counselor 926 Asylum Ave Apt 206, Hartford, CT 06105-2402 2018-09-20
1043678063 Daisy Baez Counselor 59 Nelson St, Hartford, CT 06120-2041 2016-02-04
1821495391 Halcyon Clinical Services, LLC Counselor 75 Charter Oak Ave, Hartford, CT 06106-1903 2014-11-29
1346654399 Edward Gonzalez Counselor 27 May Street 2nd Floor, Hartford, CT 06104 2014-06-18
1306100367 Marco Neves Counselor 106 Standish St, Hartford, CT 06114-2936 2012-06-25
1275804874 Ray T. Bishop Counselor 16 Weston St, Hartford, CT 06120-1504 2012-01-13
1144591710 Philip Frederick Richmond Counselor 18 Weston St, Hartford, CT 06120-1504 2012-01-13
1871862789 Latino Community Services, Inc. Counselor 221 Main St Fl 3, Hartford, CT 06106-1890 2011-12-21
1851670046 Samuel Diaz Counselor 45 Wardsworth St., Hartford, CT 06106 2011-08-05
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Competitor

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City HARTFORD
Zip Code 06112

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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