Provider Demographics
NPI:1083441174
Name:RICHARD, HEATHER ANNE (LMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:RICHARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14495 HUFF ST NE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:IN
Mailing Address - Zip Code:47164-8876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14495 HUFF ST NE
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:IN
Practice Address - Zip Code:47164-8876
Practice Address - Country:US
Practice Address - Phone:812-364-1142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004510A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health