Provider Demographics
NPI:1285075952
Name:CHAMBERLAIN, HEATHER LENORE (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LENORE
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 1ST AVE S
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3441
Mailing Address - Country:US
Mailing Address - Phone:206-414-9386
Mailing Address - Fax:
Practice Address - Street 1:216 1ST AVE S
Practice Address - Street 2:SUITE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3441
Practice Address - Country:US
Practice Address - Phone:206-414-9386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60383084101YM0800X
CO11380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health