Provider Demographics
NPI:1578190781
Name:WOODS, HEATHER (LMHC, RPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMHC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 S MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47842-2493
Mailing Address - Country:US
Mailing Address - Phone:765-828-1003
Mailing Address - Fax:
Practice Address - Street 1:777 S MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IN
Practice Address - Zip Code:47842-2493
Practice Address - Country:US
Practice Address - Phone:765-828-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health