Provider Demographics
NPI:1992512362
Name:WHITE, HEATHER FLYNN (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:FLYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:1009 PAMPA DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-2400
Mailing Address - Country:US
Mailing Address - Phone:860-276-7554
Mailing Address - Fax:
Practice Address - Street 1:100 N CENTRAL EXPY STE 613
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5326
Practice Address - Country:US
Practice Address - Phone:214-530-2324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203874101YM0800X
TX84787101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health