Provider Demographics
NPI:1639371164
Name:PREBISH, HEATHER (LCMHC, MA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PREBISH
Suffix:
Gender:F
Credentials:LCMHC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 HANOVER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1312
Practice Address - Country:US
Practice Address - Phone:603-448-0126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health