Provider Demographics
NPI:1811458631
Name:MARSHALL, HEATHER (MA, LPC, PMH-C)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MA, LPC, PMH-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:SINNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1534
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-7534
Mailing Address - Country:US
Mailing Address - Phone:724-250-0262
Mailing Address - Fax:724-416-7102
Practice Address - Street 1:1445 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9711
Practice Address - Country:US
Practice Address - Phone:724-250-0262
Practice Address - Fax:724-416-7102
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2506101YP2500X
PAPC011121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional