Provider Demographics
NPI:1215233309
Name:GOOCHEY, HEATHER L (MS, LPCC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:GOOCHEY
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12067 DUNKIRK ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-7501
Mailing Address - Country:US
Mailing Address - Phone:218-851-0571
Mailing Address - Fax:
Practice Address - Street 1:12067 DUNKIRK ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-7501
Practice Address - Country:US
Practice Address - Phone:218-851-0571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1215233309Medicaid