Provider Demographics
NPI:1710670039
Name:HUNTER, HEATHER ANN (LPC 04558)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANN
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LPC 04558
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9331 W CENTRAL AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-3816
Mailing Address - Country:US
Mailing Address - Phone:254-404-5499
Mailing Address - Fax:
Practice Address - Street 1:300 W DOUGLAS AVE STE 625
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2916
Practice Address - Country:US
Practice Address - Phone:316-302-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health