Provider Demographics
NPI:1902597925
Name:HEINLEY, WES (NCC, CRC)
Entity Type:Individual
Prefix:
First Name:WES
Middle Name:
Last Name:HEINLEY
Suffix:
Gender:M
Credentials:NCC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:CARRINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58421-2337
Mailing Address - Country:US
Mailing Address - Phone:701-650-8796
Mailing Address - Fax:
Practice Address - Street 1:700 4TH AVE S
Practice Address - Street 2:
Practice Address - City:CARRINGTON
Practice Address - State:ND
Practice Address - Zip Code:58421-2337
Practice Address - Country:US
Practice Address - Phone:701-650-8796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1178-2-1-22A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health