Provider Demographics
NPI:1659851772
Name:WIDMER, HEATHER (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WIDMER
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:WIDMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC, CAP
Mailing Address - Street 1:202 N HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1529
Mailing Address - Country:US
Mailing Address - Phone:813-254-3200
Mailing Address - Fax:
Practice Address - Street 1:202 N HOWARD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:813-254-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP6034101YA0400X
FLMH12076101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)