Provider Demographics
NPI:1790989820
Name:HEIN, KATHERINE R (LMHC-ATR)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:R
Last Name:HEIN
Suffix:
Gender:F
Credentials:LMHC-ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1312
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-1312
Mailing Address - Country:US
Mailing Address - Phone:360-221-7747
Mailing Address - Fax:
Practice Address - Street 1:1690 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-9677
Practice Address - Country:US
Practice Address - Phone:360-221-7747
Practice Address - Fax:360-221-7747
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60268785101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health