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Individual

ALEXIS G HEITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC, LCDP

Contact information

Practice address
4705A OLD POST RD, CHARLESTOWN, RI 02813-1819
(401) 364-7705
(401) 364-9104
Mailing address
4705A OLD POST RD, CHARLESTOWN, RI 02813-1819
(401) 364-7705
(401) 364-9104

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDP00470
RI
101YM0800X
Mental Health Counselor
Primary
MHC00431
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1134454556
BCBSRI
RI
01
3039767
CIGNA
RI
01
461277
MHN
RI
05
AH78980
RI
Enumeration date
10/04/2009
Last updated
03/28/2013
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