Provider Demographics
NPI:1376914804
Name:CHRISTENSEN, HEIDI LYNN (ACMHC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LYNN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 S 300 E
Mailing Address - Street 2:PO BOX 1656
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-3025
Mailing Address - Country:US
Mailing Address - Phone:435-820-0972
Mailing Address - Fax:
Practice Address - Street 1:152 S 300 E
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-3025
Practice Address - Country:US
Practice Address - Phone:435-820-0972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9362865-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health