Provider Demographics
NPI:1336496975
Name:DUDGEON, HEIDI ANN (MA, LLPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:ANN
Last Name:DUDGEON
Suffix:
Gender:F
Credentials:MA, LLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E MAPLE RD
Mailing Address - Street 2:SUITE B-7A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6426
Mailing Address - Country:US
Mailing Address - Phone:949-836-2451
Mailing Address - Fax:
Practice Address - Street 1:1025 E MAPLE RD
Practice Address - Street 2:SUITE B-7A
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6426
Practice Address - Country:US
Practice Address - Phone:949-836-2451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health