Provider Demographics
NPI:1306283114
Name:WILMARTH, HEIDI LYNN (MS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LYNN
Last Name:WILMARTH
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6157
Mailing Address - Country:US
Mailing Address - Phone:815-541-5100
Mailing Address - Fax:
Practice Address - Street 1:909 MAIN ST
Practice Address - Street 2:SUITE 505
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6712
Practice Address - Country:US
Practice Address - Phone:563-556-0699
Practice Address - Fax:563-583-3077
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health