Provider Demographics
NPI:1598754186
Name:VELEZ, HEIDI BRESLIN (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:BRESLIN
Last Name:VELEZ
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 RESEARCH FOREST DR
Mailing Address - Street 2:SUITE 180-206
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4912
Mailing Address - Country:US
Mailing Address - Phone:832-956-1099
Mailing Address - Fax:
Practice Address - Street 1:10210 GROGANS MILL RD STE 193
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1144
Practice Address - Country:US
Practice Address - Phone:832-956-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160613901Medicaid