CAROLYN J HEINEMAN PHD LLC (NPI# 1689965329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689965329 |
| Entity Type | Organization |
| Organization Name | CAROLYN J HEINEMAN PHD LLC |
| Practice Address |
5228 Lovers Ln Suite 104 Portage MI 49002-1521 |
| Practice Telephone | 2693457101 |
| Practice Fax Number | 2693457101 |
| Mailing Telephone | 2693457101 |
| Mailing Fax Number | 2693457101 |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |
| Authorized Official Name | CAROLYN J HEINEMAN (PRESIDENT) |
| Authorized Official Telephone | 2693457101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301013201 | MI | Behavioral Health & Social Service Providers |
| Street Address |
5228 LOVERS LN SUITE 104 |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669814836 | Quality Prosthetic Care | Prosthetic/Orthotic Supplier | 5228 Lovers Ln, Suite 102, Portage, MI 49002-1521 | 2013-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213631 | Robert J. Sheppard Phd Pllc | Psychologist | 8339 Brookwood Dr, Portage, MI 49024-5207 | 2020-10-23 |
| 1609994029 | Robert Alan Rodenhiser | Psychologist | 1611 W Centre, Suite 203, Portage, MI 49024 | 2007-03-26 |
| 1497899801 | Susan Christine Baird | Psychologist | 8036 Moorsbridge Rd., Suite 2, Portage, MI 49024-4419 | 2007-02-18 |
| 1285702548 | David W. Parks | Psychologist | 6337 Central Ave, Portage, IN 46368-3801 | 2006-12-02 |
| 1720015985 | Joel Schwartz | Psychologist | 5877 Central Ave Ste A, Portage, IN 46368-2920 | 2006-06-26 |
| 1609837855 | Linda L Hill | Psychologist | 3141 Willowcreek Rd, Suite F, Portage, IN 46368-4468 | 2006-03-29 |
| 1215914304 | Steven Glen Townsend | Psychologist | 8928 Portage Rd, Portage, MI 49002-6420 | 2005-12-29 |
| 1558342030 | Patricia Moulton Guilford | Psychologist | 5930 Lovers Ln, Portage, MI 49002-1673 | 2005-11-10 |
| 1730176587 | John Michael Spores | Psychologist | 3349 Willowcreek Rd, Portage, IN 46368-5015 | 2005-10-05 |
| 1013473768 | Millicent M Perkins | Psychologist | 5930 Lovers Ln, Portage, MI 49002-1673 | 2019-02-19 |
| Find all providers in PORTAGE | ||||
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| 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.