Provider Demographics
NPI:1245313675
Name:EVERS, HEIDI ANN (LPCMH)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN
Last Name:EVERS
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ANN
Other - Last Name:HOFMEISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCMH
Mailing Address - Street 1:1451 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-1604
Mailing Address - Country:US
Mailing Address - Phone:605-690-4755
Mailing Address - Fax:605-692-8997
Practice Address - Street 1:1451 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1604
Practice Address - Country:US
Practice Address - Phone:605-690-4755
Practice Address - Fax:605-692-8997
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPCMH2055101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6576000Medicaid