Provider Demographics
NPI:1770476517
Name:ORMBREK, HEIDI MIRANDA (LMHCA)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MIRANDA
Last Name:ORMBREK
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N M ST APT 6
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1503
Mailing Address - Country:US
Mailing Address - Phone:360-739-6738
Mailing Address - Fax:
Practice Address - Street 1:1320 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6500
Practice Address - Country:US
Practice Address - Phone:360-360-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61444115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health