Provider Demographics
NPI:1801988365
Name:HARTWELL, HEATHER SEALE (PHD, LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:SEALE
Last Name:HARTWELL
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 OFFICE PARK DR
Mailing Address - Street 2:STE A
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5267
Mailing Address - Country:US
Mailing Address - Phone:662-801-5028
Mailing Address - Fax:662-234-3535
Practice Address - Street 1:1202 OFFICE PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5267
Practice Address - Country:US
Practice Address - Phone:662-801-5028
Practice Address - Fax:662-234-3535
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1030101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional