Provider Demographics
NPI:1730326281
Name:BROTTON, HEATHER DAWN (LPC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DAWN
Last Name:BROTTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:DAWN
Other - Last Name:HOUSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3033 NW 63RD ST STE 160E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3612
Mailing Address - Country:US
Mailing Address - Phone:405-658-6244
Mailing Address - Fax:
Practice Address - Street 1:3033 NW 63RD ST STE 160
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3607
Practice Address - Country:US
Practice Address - Phone:405-315-7102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OK4581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor