Provider Demographics
NPI:1518246404
Name:KINGSTON, HEATHER SUE (LCMHC, MLADC, CPS)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SUE
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:LCMHC, MLADC, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PEASLEE DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275-1146
Mailing Address - Country:US
Mailing Address - Phone:603-491-2714
Mailing Address - Fax:
Practice Address - Street 1:90 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5326
Practice Address - Country:US
Practice Address - Phone:603-491-2714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0825101YA0400X
NH788101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)