Provider Demographics
NPI:1932453909
Name:HEINZE, MICHELLE CHRISTINE (LMFT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHRISTINE
Last Name:HEINZE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8565 S EASTERN AVE STE 186
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2907
Mailing Address - Country:US
Mailing Address - Phone:702-480-7692
Mailing Address - Fax:888-490-6230
Practice Address - Street 1:8565 S EASTERN AVE STE 186
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2907
Practice Address - Country:US
Practice Address - Phone:702-480-7692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1522106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist