Provider Demographics
NPI:1881303618
Name:DEJONG, HEATHER (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DEJONG
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 SUNBURY LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-0679
Mailing Address - Country:US
Mailing Address - Phone:217-619-5723
Mailing Address - Fax:
Practice Address - Street 1:5601 DEMOCRACY DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3687
Practice Address - Country:US
Practice Address - Phone:940-765-9029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional