Provider Demographics
NPI:1710115860
Name:ANDERSON, HEATHER LYNN (LMFT, LP)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:LYNN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMFT, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54064 CSAH 20
Mailing Address - Street 2:
Mailing Address - City:PAYNESVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56362-9533
Mailing Address - Country:US
Mailing Address - Phone:320-492-9668
Mailing Address - Fax:
Practice Address - Street 1:20 RED RIVER AVE S STE 100
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:MN
Practice Address - Zip Code:56320-2594
Practice Address - Country:US
Practice Address - Phone:320-407-1100
Practice Address - Fax:320-407-1120
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-28
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6667103TC0700X
MN1394106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist