Provider Demographics
NPI:1386307932
Name:CLAPHAM, HEIDI M (MC, LPC, LISAC)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:M
Last Name:CLAPHAM
Suffix:
Gender:F
Credentials:MC, LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 E BROADWAY RD STE 31
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1885
Mailing Address - Country:US
Mailing Address - Phone:480-491-4444
Mailing Address - Fax:
Practice Address - Street 1:2131 E BROADWAY RD STE 31
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1885
Practice Address - Country:US
Practice Address - Phone:480-491-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-11948101YM0800X
AZLISAC-10465101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health