Provider Demographics
NPI:1558545814
Name:CAVANESS BROWN, HEATHER M (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:CAVANESS BROWN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 POLO PARK DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-7715
Mailing Address - Country:US
Mailing Address - Phone:360-255-1787
Mailing Address - Fax:
Practice Address - Street 1:1151 ELLIS ST STE 206
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5203
Practice Address - Country:US
Practice Address - Phone:360-255-1787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60160402103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling