Provider Demographics
NPI:1356709984
Name:HEIBLUM, NAAMITH (PHD, QMHP)
Entity type:Individual
Prefix:
First Name:NAAMITH
Middle Name:
Last Name:HEIBLUM
Suffix:
Gender:F
Credentials:PHD, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SHELTON MCMURPHEY BLVD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4928
Mailing Address - Country:US
Mailing Address - Phone:541-485-2711
Mailing Address - Fax:888-975-0250
Practice Address - Street 1:10 SHELTON MCMURPHEY BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4928
Practice Address - Country:US
Practice Address - Phone:541-485-2711
Practice Address - Fax:888-975-0250
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500700319Medicaid