Provider Demographics
NPI:1467944504
Name:LEROUX-CONFER, HEIDI (QMHS, CDCA)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:LEROUX-CONFER
Suffix:
Gender:F
Credentials:QMHS, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6958
Mailing Address - Country:US
Mailing Address - Phone:419-297-9553
Mailing Address - Fax:
Practice Address - Street 1:115 S REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6958
Practice Address - Country:US
Practice Address - Phone:419-297-9553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172113101YA0400X
OHCDCA172113171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)