Provider Demographics
NPI:1235566787
Name:SISEL, HEATHER M (MSED, PLMHP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:SISEL
Suffix:
Gender:F
Credentials:MSED, PLMHP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:NOVACEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, PLMHP
Mailing Address - Street 1:5600 S 59TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2387
Mailing Address - Country:US
Mailing Address - Phone:402-484-0595
Mailing Address - Fax:402-484-6306
Practice Address - Street 1:2444 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1125
Practice Address - Country:US
Practice Address - Phone:402-475-7666
Practice Address - Fax:402-476-9623
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9977101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health