Provider Demographics
NPI:1275053282
Name:CRAMPTON, HEATHER LYNNE-BEATRICE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNNE-BEATRICE
Last Name:CRAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8126 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-5659
Mailing Address - Country:US
Mailing Address - Phone:269-743-9595
Mailing Address - Fax:
Practice Address - Street 1:350 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3800
Practice Address - Country:US
Practice Address - Phone:269-359-1873
Practice Address - Fax:269-312-8781
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional