Provider Demographics
NPI:1902123144
Name:BECKER, HEATHER H (LMFT(TEMP))
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:H
Last Name:BECKER
Suffix:
Gender:F
Credentials:LMFT(TEMP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7526 E 82ND ST STE 150
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1492
Mailing Address - Country:US
Mailing Address - Phone:317-585-1060
Mailing Address - Fax:317-585-9811
Practice Address - Street 1:7526 E 82ND ST STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1492
Practice Address - Country:US
Practice Address - Phone:317-585-1060
Practice Address - Fax:317-585-9811
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001702A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist