Provider Demographics
NPI:1477537678
Name:HEIM, LUANN LENGAS (MS LP)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:LENGAS
Last Name:HEIM
Suffix:
Gender:F
Credentials:MS LP
Other - Prefix:
Other - First Name:LUANN
Other - Middle Name:
Other - Last Name:LENGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1930 COON RAPIDS BOULEVARD
Mailing Address - Street 2:FAMILY LIFE MENTAL HEALTH CENTER
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433
Mailing Address - Country:US
Mailing Address - Phone:763-746-9583
Mailing Address - Fax:763-746-9597
Practice Address - Street 1:1930 COON RAPIDS BOULEVARD
Practice Address - Street 2:FAMILY LIFE MENTAL HEALTH CENTER
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:763-427-7964
Practice Address - Fax:763-427-7976
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 2803103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1022557OtherPREFERRED ONE
304J3HEOtherBC/BS BLUE PLUS
MN5H514HEOtherBCBS
6248962OtherUBH
421152OtherVALUE OPTIONS
106985OtherU CARE
6278962OtherMEDICA/SELECTCARE
HP25544OtherHEALTH PARTNERS