Basic Information
Provider Information
NPI: 1184381865
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SITES
FirstName: HEATHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4465 RICHMOND AVE
Address2:  
City: NEWTON FALLS
State: OH
PostalCode: 444441484
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5548 HILLIARD ROME OFFICE PARK
Address2:  
City: HILLIARD
State: OH
PostalCode: 430267286
CountryCode: US
TelephoneNumber: 7408458652
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/17/2021
LastUpdateDate: 11/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XE2012602OHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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