Provider Demographics
NPI:1902577893
Name:HEINTZ, KERRI (LPC)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:HEINTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 LEGACY PKWY
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-1321
Mailing Address - Country:US
Mailing Address - Phone:504-251-4366
Mailing Address - Fax:
Practice Address - Street 1:7703 LEGACY PKWY
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-1321
Practice Address - Country:US
Practice Address - Phone:504-251-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82483101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty