Provider Demographics
NPI:1871272831
Name:HEINMETS, LORELEI ELISE
Entity type:Individual
Prefix:
First Name:LORELEI
Middle Name:ELISE
Last Name:HEINMETS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAI
Other - Middle Name:
Other - Last Name:HEINMETS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1170 OLD US HWY 70 W APT 1
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-2781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1170 OLD US HWY 70 W APT 1
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-2781
Practice Address - Country:US
Practice Address - Phone:619-400-9008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician