Provider Demographics
NPI:1043358203
Name:FRANTUM-MATHES, HEATHER (LMFT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:FRANTUM-MATHES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SAINT ANDREWS CT STE 710
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-8815
Mailing Address - Country:US
Mailing Address - Phone:507-386-7121
Mailing Address - Fax:507-344-0690
Practice Address - Street 1:151 SAINT ANDREWS CT STE 710
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8815
Practice Address - Country:US
Practice Address - Phone:507-386-7121
Practice Address - Fax:507-344-0690
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1290106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN990991045427OtherPREFERRED ONE INDIV #
MN819613300Medicaid
MNHP55898OtherHEALTH PARTNERS INDIV #
MN136621OtherUCARE INDIVIDUAL #
MN431M6FROtherBCBS INDIVIDUAL #