Basic Information
| Provider Information | |||||||||
| NPI: | 1689909517 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HESKETH | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., LMHC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HESKETH | ||||||||
| OtherFirstName: | FRANCIS | ||||||||
| OtherMiddleName: | J | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MA, LMHC | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 677 WOODLAND SQUARE LOOP SE | ||||||||
| Address2: | |||||||||
| City: | LACEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985031000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605848929 | ||||||||
| FaxNumber: | 3603528868 | ||||||||
| Practice Location | |||||||||
| Address1: | 677 WOODLAND SQUARE LOOP SE | ||||||||
| Address2: | |||||||||
| City: | LACEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985031000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605848929 | ||||||||
| FaxNumber: | 3603528868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2009 | ||||||||
| LastUpdateDate: | 01/04/2014 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LH 60439126 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.