Provider Demographics
NPI:1831710078
Name:WEAVER, HEATHER LINNEA (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LINNEA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LINNEA
Other - Last Name:HOVLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:IA
Mailing Address - Zip Code:50643-0394
Mailing Address - Country:US
Mailing Address - Phone:701-500-0466
Mailing Address - Fax:
Practice Address - Street 1:604 8TH ST
Practice Address - Street 2:
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-1328
Practice Address - Country:US
Practice Address - Phone:800-531-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100285101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health