Provider Demographics
NPI:1003669771
Name:JAMESON, HEIDI E (MS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:E
Last Name:JAMESON
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 OAK DR
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-9417
Mailing Address - Country:US
Mailing Address - Phone:863-268-5802
Mailing Address - Fax:
Practice Address - Street 1:148 OAK DR
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-9417
Practice Address - Country:US
Practice Address - Phone:863-268-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health