Provider Demographics
NPI:1619694320
Name:MAURER, HEATHER (CADC-R)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MAURER
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20674
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97307-0674
Mailing Address - Country:US
Mailing Address - Phone:503-304-4358
Mailing Address - Fax:503-304-4361
Practice Address - Street 1:2586 12TH PL SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2536
Practice Address - Country:US
Practice Address - Phone:503-371-4160
Practice Address - Fax:503-375-9727
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-22-1563101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)