Provider Demographics
NPI:1750952180
Name:CANEY, HEATHER MICHELE HALL (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MICHELE HALL
Last Name:CANEY
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 1:1170 HANNAHS MILL RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-2828
Mailing Address - Country:US
Mailing Address - Phone:706-975-3500
Mailing Address - Fax:
Practice Address - Street 1:420 THOMASTON ST
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:GA
Practice Address - Zip Code:30295-3387
Practice Address - Country:US
Practice Address - Phone:404-960-1282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010258101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional