Provider Demographics
NPI:1992802904
Name:HENRIKSEN, HEATHER MARIE (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:HENRIKSEN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:PEDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,LMHC
Mailing Address - Street 1:37 S WENATCHEE AVE STE H
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2243
Mailing Address - Country:US
Mailing Address - Phone:509-312-1723
Mailing Address - Fax:
Practice Address - Street 1:37 S WENATCHEE AVE STE H
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2243
Practice Address - Country:US
Practice Address - Phone:509-312-1723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH00010016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA910564952OtherFIRST CHOICE NETWORK
WA910564952OtherFIRST CHOICE HEALTH NETWORK