Provider Demographics
NPI:1760695308
Name:HEIM, YVONNE L (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:L
Last Name:HEIM
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ROUNDUP DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2309
Mailing Address - Country:US
Mailing Address - Phone:830-481-6333
Mailing Address - Fax:
Practice Address - Street 1:104 ROUNDUP DR
Practice Address - Street 2:
Practice Address - City:CASTLE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78213-2309
Practice Address - Country:US
Practice Address - Phone:830-481-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10979101YA0400X
TX72546101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10979OtherLICENSED CHEMICAL DEPENDENCY COUNSELOR
TX72546OtherLICENSED PROFESSIONAL COUNSELOR