Provider Demographics
NPI:1467223404
Name:HEIDI LYNN WILMARTH MS, LMHC
Entity Type:Organization
Organization Name:HEIDI LYNN WILMARTH MS, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR- MENTAL HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WILMARTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:815-541-5100
Mailing Address - Street 1:2254 FLINT HILL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-8097
Mailing Address - Country:US
Mailing Address - Phone:815-541-5100
Mailing Address - Fax:
Practice Address - Street 1:2254 FLINT HILL DR STE 2
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-8097
Practice Address - Country:US
Practice Address - Phone:413-216-5423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty