Provider Demographics
NPI:1295860526
Name:KLOSS, HEIDI MAE (PHD, ATR-BC, LPCC-S)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:MAE
Last Name:KLOSS
Suffix:
Gender:F
Credentials:PHD, ATR-BC, LPCC-S
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MAE
Other - Last Name:SLITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:24600 CENTER RIDGE ROAD
Mailing Address - Street 2:SUITE 285
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5691
Mailing Address - Country:US
Mailing Address - Phone:216-313-8875
Mailing Address - Fax:440-471-7055
Practice Address - Street 1:24600 CENTER RIDGE ROAD
Practice Address - Street 2:SUITE 285
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5691
Practice Address - Country:US
Practice Address - Phone:216-313-8875
Practice Address - Fax:440-471-7055
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCS1830400299Medicaid