Provider Demographics
NPI:1639492788
Name:CONLIN, HEIDI RENEE (MS, LPCI, LMFTA)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:RENEE
Last Name:CONLIN
Suffix:
Gender:F
Credentials:MS, LPCI, LMFTA
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:RENEE
Other - Last Name:HADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 E HOUSTON ST 7TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205
Mailing Address - Country:US
Mailing Address - Phone:210-572-4931
Mailing Address - Fax:833-606-0679
Practice Address - Street 1:110 E HOUSTON ST 7TH FLOOR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-572-4931
Practice Address - Fax:833-606-0679
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201300106H00000X
TX64720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist