Provider Demographics
NPI:1104964899
Name:REMINGTON, HEATHER HELEN (LCPC)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:HELEN
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2340
Mailing Address - Country:US
Mailing Address - Phone:406-563-8117
Mailing Address - Fax:
Practice Address - Street 1:CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:MT
Practice Address - Zip Code:59421-8356
Practice Address - Country:US
Practice Address - Phone:406-468-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0255374Medicaid
MT0035867Medicaid