Provider Demographics
NPI:1679128326
Name:HARTLEROAD, HEATHER (LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HARTLEROAD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21699 E QUINCY AVE UNIT F
Mailing Address - Street 2:#352
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015
Mailing Address - Country:US
Mailing Address - Phone:303-550-5729
Mailing Address - Fax:
Practice Address - Street 1:21699 E QUINCY AVE UNIT F
Practice Address - Street 2:#352
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015
Practice Address - Country:US
Practice Address - Phone:303-550-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional