Provider Demographics
NPI:1023985967
Name:LORENZ, HEAVEN LEIGH (TCADC)
Entity type:Individual
Prefix:
First Name:HEAVEN
Middle Name:LEIGH
Last Name:LORENZ
Suffix:
Gender:F
Credentials:TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1649
Mailing Address - Country:US
Mailing Address - Phone:641-414-6079
Mailing Address - Fax:
Practice Address - Street 1:219 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1249
Practice Address - Country:US
Practice Address - Phone:641-342-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT25096101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)