Provider Demographics
NPI:1508821943
Name:STELMOK, HEATHER MORGAN (LMHC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MORGAN
Last Name:STELMOK
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2615
Mailing Address - Country:US
Mailing Address - Phone:941-960-2565
Mailing Address - Fax:941-952-1711
Practice Address - Street 1:1500 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-960-2565
Practice Address - Fax:941-952-1711
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4597101Y00000X
FLMH12662101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140F6OtherBCBS
NC6102387Medicaid