Provence, Heather Lynne

Provence, Heather Lynne is an individual health care provider with primary practice located at 890 Mountain Ave Behavioral Health & Cognitive Therapy, New Providence NJ 07974. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Provence, Heather Lynne can be contacted via phone (908) 277-8900.

Contact Information

Primary practice address
890 Mountain Ave Behavioral Health & Cognitive Therapy New Providence NJ 07974
Phone: (908) 277-8900
Fax: (908) 508-8919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F402394-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 26NJ01289400 New Jersey

Profile Details

NPI number 1295221612
LBN Legal business name Provence, Heather Lynne
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2018
Last updated Jul 3rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295221612 NPPES
New York MEDICAID 05265370

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