Provider Demographics
NPI:1760498711
Name:PIERCE, HEATHER FITZPATRICK (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:FITZPATRICK
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 STATE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3301
Mailing Address - Country:US
Mailing Address - Phone:802-279-7808
Mailing Address - Fax:802-223-2627
Practice Address - Street 1:159 STATE ST STE 105
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3301
Practice Address - Country:US
Practice Address - Phone:802-279-7808
Practice Address - Fax:802-223-2627
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680000509101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009538Medicaid