Healthcare Provider Details

I. General information

NPI: 1548492614
Provider Name (Legal Business Name): DEBORAH HEIKES LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST STE O
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

2105 VISTA OESTE NW STE E-1814
ALBUQUERQUE NM
87120-3693
US

V. Phone/Fax

Practice location:
  • Phone: 505-500-6187
  • Fax:
Mailing address:
  • Phone: 505-500-6187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0120501
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: