Provider Demographics
NPI:1669802088
Name:SCHILTZ, HEIDI (LPCC)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:SCHILTZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38414 40TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMORE
Mailing Address - State:MN
Mailing Address - Zip Code:56027-2089
Mailing Address - Country:US
Mailing Address - Phone:507-943-3602
Mailing Address - Fax:
Practice Address - Street 1:1420 N STATE ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3619
Practice Address - Country:US
Practice Address - Phone:507-235-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC000404101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCC00404OtherLICENSE