Provider Demographics
NPI:1538472170
Name:LONGAUER, HEIDI M (MED, LPC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:LONGAUER
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 OWENS ST APT D
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5585
Mailing Address - Country:US
Mailing Address - Phone:440-759-5997
Mailing Address - Fax:
Practice Address - Street 1:7400 E ARAPAHOE RD STE 212
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1281
Practice Address - Country:US
Practice Address - Phone:303-741-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-25
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 0800296101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health