Provider Demographics
NPI:1588976203
Name:ROWLEY, HEATHER M (MAED, LPC, CMHC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:M
Last Name:ROWLEY
Suffix:
Gender:F
Credentials:MAED, LPC, CMHC
Other - Prefix:
Other - First Name:ADVANTAGE
Other - Middle Name:COUNSELING
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMHC
Mailing Address - Street 1:11576 S STATE ST
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-6431
Mailing Address - Country:US
Mailing Address - Phone:801-930-0575
Mailing Address - Fax:
Practice Address - Street 1:11576 S STATE ST
Practice Address - Street 2:SUITE 1001
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-6431
Practice Address - Country:US
Practice Address - Phone:801-930-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6224141-6004101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT823155104Medicaid