Provider Demographics
NPI:1528425915
Name:HOPE, HEATHER (LPC-IT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HOPE
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 E MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-2202
Mailing Address - Country:US
Mailing Address - Phone:920-221-6112
Mailing Address - Fax:
Practice Address - Street 1:731 E MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-2202
Practice Address - Country:US
Practice Address - Phone:920-221-6112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1477-266101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor