Provider Demographics
NPI:1760084941
Name:MARSCHEIDER, HEATHER M (MA, LLP, LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:MARSCHEIDER
Suffix:
Gender:F
Credentials:MA, LLP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PARKLANE BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4206
Mailing Address - Country:US
Mailing Address - Phone:313-649-7382
Mailing Address - Fax:
Practice Address - Street 1:6 PARKLANE BLVD STE 122
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4206
Practice Address - Country:US
Practice Address - Phone:313-649-7382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223036101Y00000X
MI6361007610103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty