Provider Demographics
NPI:1790145613
Name:HEINER, PATRICIA MARGARITA (MA, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARGARITA
Last Name:HEINER
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6631 CABIN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-9220
Mailing Address - Country:US
Mailing Address - Phone:719-213-4102
Mailing Address - Fax:
Practice Address - Street 1:6631 CABIN CREEK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-9220
Practice Address - Country:US
Practice Address - Phone:719-213-4102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012889101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional