Provider Demographics
NPI:1639535644
Name:HEIM, KARIN I (LCPC-C)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:I
Last Name:HEIM
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3005
Mailing Address - Country:US
Mailing Address - Phone:207-299-1414
Mailing Address - Fax:
Practice Address - Street 1:49 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3005
Practice Address - Country:US
Practice Address - Phone:207-299-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional