Provider Demographics
NPI:1336539923
Name:GRABER, HEIDI (LMHC, LPC)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:GRABER
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 JAMES KELLY LN
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-7039
Mailing Address - Country:US
Mailing Address - Phone:904-327-1395
Mailing Address - Fax:
Practice Address - Street 1:2230 JAMES KELLY LN
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-7039
Practice Address - Country:US
Practice Address - Phone:904-327-1395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012213101Y00000X
FLMH13121101YM0800X
101YM0800X
WI11304-125101YM0800X
COLPC0016759101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor