Provider Demographics
NPI:1154374452
Name:SOUTHER, HEATHER J (LCMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:J
Last Name:SOUTHER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:J
Other - Last Name:RAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 TSIENNETO RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1505
Mailing Address - Country:US
Mailing Address - Phone:603-434-1577
Mailing Address - Fax:603-434-3101
Practice Address - Street 1:10 TSIENNETO RD
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1505
Practice Address - Country:US
Practice Address - Phone:603-434-1577
Practice Address - Fax:603-434-3101
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHLCMHC469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health