Provider Demographics
NPI:1962274118
Name:STAPLES, HEIDI DENISE (LPC)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:DENISE
Last Name:STAPLES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:DENISE
Other - Last Name:LEINWEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1303 HEAVENS PEAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7296
Mailing Address - Country:US
Mailing Address - Phone:210-325-0276
Mailing Address - Fax:
Practice Address - Street 1:1303 HEAVENS PEAK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7296
Practice Address - Country:US
Practice Address - Phone:210-325-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional