MICHAEL HEFFERNAN (NPI# 1588738603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588738603 |
| Entity Type | Individual |
| Full Name | MICHAEL HEFFERNAN |
| Credential | LICSW, LCDP |
| Practice Address |
345 Blackstone Blvd Providence RI 02906-4800 |
| Mailing Address |
41 Norman Ave Cranston RI 02910-5812 |
| Practice Telephone | 4014217900 |
| Mailing Telephone | 4019410804 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCDP 00193 | RI | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
ISW 00358 | RI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RI BLUECROSS-BLUESHIELD | 23588-4 | 01 |
| RI | RI BLUECROSS-BLUECHIP | 205032 | 01 |
| RI | UNITEDBEHAVIORALHEALTH | 62-52319 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457349920 | Michael Heffernan | Psychologist | 408 N Third Street, Fulton, TX 78358 | 2005-10-10 |
| 1326675802 | Michael Heffernan | Physician Assistant | 278 Eagleview Blvd, Exton, PA 19341-1157 | 2020-03-25 |
| 1326359506 | Michael Adam Heffernan | Physical Therapist | 2032 New Castle Ave, New Castle, DE 19720-7703 | 2010-06-23 |
| 1750588836 | Michael Heffernan | Orthopaedic Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2007-07-02 |
| 1518923432 | Michael P Heffernan | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-04-21 |
| Street Address |
345 BLACKSTONE BLVD |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203690 | Andrew Seth Rosenzweig | Psychiatry & Neurology | 345 Blackstone Blvd, Rm. 232 2nd Floor Annex Building, Providence, RI 02906-4800 | 2005-05-24 |
| 1356940860 | Diane Medeiros Gomes | Pharmacist | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-10-26 |
| 1013528199 | Michael Gunson | Physician Assistant | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-08-12 |
| 1902423775 | Elyssa Sham | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-28 |
| 1407472400 | Amy Rebecca Johnson | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-25 |
| 1669096772 | Olivia Hunt | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-04 |
| 1922622125 | Carla Julia Hasson | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906 | 2020-06-03 |
| 1023632395 | Micah Benjamin Duggins-warf | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-03 |
| 1982228060 | Armond Collins | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-03 |
| 1508485301 | Brian Charles Castelluccio | Clinical Neuropsychologist | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1952873317 | Better Care Transport LLC | Counselor | 448 Public St, Providence, RI 02907-1223 | 2018-12-26 |
| 1407234172 | David Lee Russell Jr. | Counselor | 60 Comstock Ave, Providence, RI 02907-1206 | 2015-05-13 |
| 1558755082 | Souad Cheteyan | Counselor | 315 Mount Pleasant Ave, Providence, RI 02908-3836 | 2015-03-23 |
| 1588081533 | Nicole Ann Hutto | Counselor | 20 Vandieman Ave, Providence, RI 02909-5560 | 2014-03-27 |
| 1396050597 | Daniel D Strother | Counselor | 66 Pavilion Ave., Providence, RI 02905 | 2010-08-11 |
| 1902137748 | Lux Maria Taylor | Counselor | 662 Hartford Ave, Providence, RI 02909-5917 | 2010-01-19 |
| 1780805283 | Marcel A Trisvan | Counselor | Codac Providence, 349 Huntington Ave, Providence, RI 02909 | 2007-05-01 |
| 1316063829 | Digna Marrero | Counselor | 16 Borinquen St, 662 Hartford Ave., Providence, RI 02905-3202 | 2007-03-22 |
| 1467554634 | George Edward Benedict | Counselor | Providence Vamc, 830 Chalkstone Avenue, Providence, RI 02908-4799 | 2006-09-01 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
Please comment or provide details below to improve the information on MICHAEL HEFFERNAN.
| 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.