Provider Demographics
NPI:1346590189
Name:ZIEMBA, HEATHER LEA GLENNEY (PHD, LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER LEA
Middle Name:GLENNEY
Last Name:ZIEMBA
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LEA
Other - Last Name:GLENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:119 LAFAYETTE ST.
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-889-0097
Mailing Address - Fax:860-822-6672
Practice Address - Street 1:119 LAFAYETTE ST.
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-889-0097
Practice Address - Fax:860-822-6672
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002235101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health