Provider Demographics
NPI:1851475503
Name:HEINE, CAROLE S (LMHC)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:S
Last Name:HEINE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9395 LINDER WAY NW
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9149
Mailing Address - Country:US
Mailing Address - Phone:360-307-7010
Mailing Address - Fax:360-307-9170
Practice Address - Street 1:9395 LINDER WAY NW
Practice Address - Street 2:SUITE # 202
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9149
Practice Address - Country:US
Practice Address - Phone:360-307-7010
Practice Address - Fax:360-307-9170
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health