Provider Demographics
NPI:1588653224
Name:PUGH, HEATHER (LMHC, SAP, CAP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:PUGH
Suffix:
Gender:F
Credentials:LMHC, SAP, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 VENETIAN HARBOR DR NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-1915
Mailing Address - Country:US
Mailing Address - Phone:727-743-8446
Mailing Address - Fax:
Practice Address - Street 1:13575 58TH ST N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3746
Practice Address - Country:US
Practice Address - Phone:727-743-8446
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP2119101YA0400X
FLMH6410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health