Provider Demographics
NPI:1740650613
Name:CONOVER, HEATHER MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:CONOVER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 NE CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-9534
Mailing Address - Country:US
Mailing Address - Phone:712-371-2846
Mailing Address - Fax:515-410-1329
Practice Address - Street 1:5619 NW 86TH ST STE 500
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2955
Practice Address - Country:US
Practice Address - Phone:712-354-6230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health