Provider Demographics
NPI:1285131359
Name:CASSIDY, HEATHER M (MS, LPCC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:BRINKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:7401 METRO BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3062
Mailing Address - Country:US
Mailing Address - Phone:612-268-5858
Mailing Address - Fax:612-268-5868
Practice Address - Street 1:1550 AMERICAN BLVD E STE 550
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1139
Practice Address - Country:US
Practice Address - Phone:612-268-5858
Practice Address - Fax:612-268-5868
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2251101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2251OtherPROFESSIONAL LICENSE