Healthcare Provider Details

I. General information

NPI: 1659636355
Provider Name (Legal Business Name): HEIDI JOY HADEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 W HOLMES AVE
MESA AZ
85210-5157
US

IV. Provider business mailing address

461 W HOLMES AVE UNIT 134
MESA AZ
85210-5163
US

V. Phone/Fax

Practice location:
  • Phone: 520-709-1777
  • Fax:
Mailing address:
  • Phone: 520-709-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-13802
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: