Provider Demographics
NPI:1558775957
Name:WIEN, HEATHER (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WIEN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SALMON CREEK LANE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-4410
Mailing Address - Country:US
Mailing Address - Phone:907-364-4410
Mailing Address - Fax:
Practice Address - Street 1:831 S PERRY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1919
Practice Address - Country:US
Practice Address - Phone:720-707-6747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0104285101YA0400X, 101YM0800X
COLPC.0012966101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health