Provider Demographics
NPI:1023163276
Name:FIEDLER, HEATHER (MA, NPC, LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:MA, NPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 STONES THROW
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-9649
Mailing Address - Country:US
Mailing Address - Phone:570-236-8838
Mailing Address - Fax:570-895-9266
Practice Address - Street 1:RT 390 BOX 41
Practice Address - Street 2:
Practice Address - City:MOUNTAINHOME
Practice Address - State:PA
Practice Address - Zip Code:18342
Practice Address - Country:US
Practice Address - Phone:570-595-0950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003209101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC003209OtherCOUNSELOR LICENSE