JUSTIN ANTHONY HEUPEL


Address: 301 Kent St Ste 2, Iron Mountain, MI 49801-1569
Phone: 9067742561

JUSTIN ANTHONY HEUPEL (NPI# 1134699028) 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) 1134699028
Entity Type Individual
Full Name JUSTIN ANTHONY HEUPEL
Credential MA
Practice Address 301 Kent St Ste 2
Iron Mountain
MI 49801-1569
Mailing Address 97 S 4th St Ste C
Ishpeming
MI 49849-2168
Practice Telephone 9067742561
Practice Fax Number 9067742597
Mailing Telephone 9062289699
Mailing Fax Number 8889772109
Enumeration Date 2018-12-04
Last Update Date 2020-11-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist 6301017696 MI Behavioral Health & Social Service Providers
Y 103TA0400X Psychologist
Specialization: Addiction (Substance Use Disorder)
6362001527 MI Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
401 10th Ave, Menominee, MI 498583009 9068637841
305 W Genesee St Ste 3, Iron River, MI 499351361 9062144777 9062144776

Office Location

Street Address 301 KENT ST STE 2
City IRON MOUNTAIN
State MI
Zip Code 49801-1569

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Taxonomy Information

Taxonomy Code 103TA0400X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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1861748238 Pro Med Substance Abuse Program LLC Psychologist 2891 E. Maple Rd. Suite 200, Troy, MI 48083 2012-08-03
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1972860005 Samaritas Psychologist 128 S Cochran Ave, Charlotte, MI 48813-1510 2012-04-13
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Competitor

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City IRON MOUNTAIN
Zip Code 49801

Improve Information

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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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