Provider Demographics
NPI:1639474901
Name:BROOME, HEATHER BROOKE HANSON (LMHC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:BROOKE HANSON
Last Name:BROOME
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 WELLS AVE S UNIT A
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2786
Mailing Address - Country:US
Mailing Address - Phone:206-566-9853
Mailing Address - Fax:
Practice Address - Street 1:306 WELLS AVE S UNIT A
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2786
Practice Address - Country:US
Practice Address - Phone:206-566-9853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60770357101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health