Provider Demographics
NPI:1154095859
Name:SUGUITAN, HEIDI E (LPC, LCPC, ATR-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:E
Last Name:SUGUITAN
Suffix:
Gender:F
Credentials:LPC, LCPC, ATR-BC
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:E
Other - Last Name:HARBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LCPC, ATR-BC
Mailing Address - Street 1:8000 BONHOMME AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3515
Mailing Address - Country:US
Mailing Address - Phone:314-492-7147
Mailing Address - Fax:
Practice Address - Street 1:8000 BONHOMME AVE STE 312
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3515
Practice Address - Country:US
Practice Address - Phone:314-492-7147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006752101YP2500X
10030221700000X
MO2009035602101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist