Provider Demographics
NPI:1568829760
Name:EISENHAUER, HEATHER L (LMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:EISENHAUER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146L ARSENAL ST
Mailing Address - Street 2:STE 10A
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-6550
Mailing Address - Country:US
Mailing Address - Phone:315-343-3344
Mailing Address - Fax:
Practice Address - Street 1:146L ARSENAL STREET
Practice Address - Street 2:SUITE 10A
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-2097
Practice Address - Country:US
Practice Address - Phone:315-343-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health