Provider Demographics
NPI:1326532631
Name:CAMERON, HEATHER (CACII)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80040-0919
Mailing Address - Country:US
Mailing Address - Phone:303-825-8113
Mailing Address - Fax:
Practice Address - Street 1:4242 DELWARE STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216
Practice Address - Country:US
Practice Address - Phone:303-825-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COABC.0007005101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COABC.0007005OtherDEPARTMENT OF REGULATORY AGENCIES