Provider Demographics
NPI:1023027562
Name:WINN, HEIDI SUZANNE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:SUZANNE
Last Name:WINN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 NORTH COURT STREET
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556
Mailing Address - Country:US
Mailing Address - Phone:641-919-6232
Mailing Address - Fax:207-282-7509
Practice Address - Street 1:2 SPRINGBROOK DRIVE
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-282-1500
Practice Address - Fax:207-282-7509
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC887101YP2500X
IA001163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME329230099Medicaid