Provider Demographics
NPI:1255022901
Name:DAMPIER, HEIDI MARIE (LPC-IT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:DAMPIER
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 RIPPLING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-6682
Mailing Address - Country:US
Mailing Address - Phone:715-218-2048
Mailing Address - Fax:
Practice Address - Street 1:3704 WESTON AVE
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-5242
Practice Address - Country:US
Practice Address - Phone:715-298-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7343-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional