Provider Demographics
NPI:1457639338
Name:ELD, HEIDI A (M A, L C P C)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:A
Last Name:ELD
Suffix:
Gender:F
Credentials:M A, L C P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6298 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-9169
Mailing Address - Country:US
Mailing Address - Phone:208-794-1509
Mailing Address - Fax:
Practice Address - Street 1:82 S BALTIC PL STE 103
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-5935
Practice Address - Country:US
Practice Address - Phone:208-794-1509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
ID5340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional