Provider Demographics
NPI:1073594982
Name:WEIPERT, HEIDI DEBORAH (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:DEBORAH
Last Name:WEIPERT
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 PECK ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-2530
Mailing Address - Country:US
Mailing Address - Phone:231-722-7770
Mailing Address - Fax:231-722-7677
Practice Address - Street 1:1633 PECK ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2530
Practice Address - Country:US
Practice Address - Phone:231-722-7770
Practice Address - Fax:231-722-7677
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007895101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIWEIPE0012Medicaid