Provider Demographics
NPI:1164889234
Name:BARDEN, HEATHER NICOLE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:BARDEN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 101ST ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-4074
Mailing Address - Country:US
Mailing Address - Phone:806-370-0335
Mailing Address - Fax:
Practice Address - Street 1:3403 73RD ST
Practice Address - Street 2:SUITE 16
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1101
Practice Address - Country:US
Practice Address - Phone:806-370-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional