BRIAN F. HEATHERTON (NPI# 1235152901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235152901 |
| Entity Type | Individual |
| Full Name | BRIAN F. HEATHERTON |
| Credential | PH.D. |
| Practice Address |
202 E Locust St Bloomington IL 61701-3006 |
| Mailing Address |
Po Box 2451 Bloomington IL 61702-2451 |
| Practice Telephone | 3092683529 |
| Practice Fax Number | 3092682323 |
| Mailing Telephone | 3092682172 |
| Mailing Fax Number | 3092682364 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
IL | Behavioral Health & Social Service Providers | |
| X | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 05732028 | 01 |
| Street Address |
202 E LOCUST ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033132790 | Cheri L. Miller | Psychologist | 202 E Locust St, Bloomington, IL 61701-3006 | 2006-07-25 |
| 1245250166 | Paula D. Lodge | Counselor | 202 E Locust St, Bloomington, IL 61701-3006 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917728 | Courtney Caryl Breyer | Counselor | 1701 American Blvd E Ste 4, Bloomington, MN 55425-1402 | 2020-06-17 |
| 1841832938 | Elizabeth Simon Simon | Counselor | 9193 S Greenridge Ln, Bloomington, IN 47401-9015 | 2019-10-10 |
| 1396220703 | Elizabeth Michelle Utterback | Counselor | 4633 W Richland Plaza Dr, Bloomington, IN 47404-9776 | 2018-10-02 |
| 1003316720 | William Douglas Portis | Counselor | 808 S Eldorado Rd Ste 100c, Bloomington, IL 61704-6075 | 2018-02-19 |
| 1346601804 | Colette Maureen Bisanz-haas | Counselor | 9301 Bryant Ave S Ste 107, Bloomington, MN 55420-3438 | 2016-03-11 |
| 1952791733 | Ryan Conway | Counselor | 900 E 7th St, M005, Bloomington, IN 47405-3905 | 2015-01-30 |
| 1629487749 | Deborah C Wilkin | Counselor | 455 E Wylie Farm Rd, Bloomington, IN 47401-4591 | 2014-08-04 |
| 1518208206 | Jeremy Keith Davis | Counselor | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2013-03-06 |
| 1053691717 | Finding Your Path To Freedom | Counselor | 2310 E Oakland Ave Ste 11b, Bloomington, IL 61701-5881 | 2011-08-25 |
| 1528376985 | Countermeasures, Inc. | Counselor | 110 N. Center, Bloomington, IL 61701-5002 | 2010-09-20 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
Please comment or provide details below to improve the information on BRIAN F. HEATHERTON.
| 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.