Provider Demographics
NPI:1245978253
Name:HEIDI GOERZEN COUNSELING, LLC
Entity type:Organization
Organization Name:HEIDI GOERZEN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOERZEN
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:574-312-9342
Mailing Address - Street 1:114 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-8938
Mailing Address - Country:US
Mailing Address - Phone:620-869-9986
Mailing Address - Fax:620-869-9046
Practice Address - Street 1:114 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-8938
Practice Address - Country:US
Practice Address - Phone:620-869-9986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty