Provider Demographics
NPI:1841726353
Name:BARTLETT, HEATHER
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:SCHIEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, LLPC
Mailing Address - Street 1:630 S WOODCOCK RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-8949
Mailing Address - Country:US
Mailing Address - Phone:989-615-8018
Mailing Address - Fax:
Practice Address - Street 1:630 S WOODCOCK RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-8949
Practice Address - Country:US
Practice Address - Phone:989-615-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401011553OtherLLPC LICENSE NUMBER