Provider Demographics
NPI:1326286212
Name:VAN DOEREN, HEIDI (MSED, LPC, CAC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:VAN DOEREN
Suffix:
Gender:F
Credentials:MSED, LPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5867 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1601
Mailing Address - Country:US
Mailing Address - Phone:412-521-3688
Mailing Address - Fax:
Practice Address - Street 1:5867 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1601
Practice Address - Country:US
Practice Address - Phone:412-521-3688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000067101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional