Basic Information
Provider Information
NPI: 1679517841
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITNEY
FirstName: HEIDI
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 701 N MILLER ST
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988012086
CountryCode: US
TelephoneNumber: 5096627105
FaxNumber: 5096638201
Practice Location
Address1: 701 N MILLER ST
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988012086
CountryCode: US
TelephoneNumber: 5096627195
FaxNumber: 5096621269
Other Information
ProviderEnumerationDate: 06/16/2006
LastUpdateDate: 05/19/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XLH00005119WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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