Provider Demographics
NPI:1104452564
Name:THURMES, HEATHER (MA,LADC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:THURMES
Suffix:
Gender:F
Credentials:MA,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 7TH ST W STE 302
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3068
Mailing Address - Country:US
Mailing Address - Phone:651-300-2182
Mailing Address - Fax:
Practice Address - Street 1:555 7TH ST W STE 302
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3068
Practice Address - Country:US
Practice Address - Phone:651-300-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)