Provider Demographics
NPI:1023170594
Name:HARDING, HEATHER R (LMHC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:HARDING
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 1:13741 MOONSTONE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-3505
Mailing Address - Country:US
Mailing Address - Phone:813-727-0846
Mailing Address - Fax:
Practice Address - Street 1:1304 S DE SOTO AVE STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3201
Practice Address - Country:US
Practice Address - Phone:813-727-0846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7804101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107733300Medicaid