Healthcare Provider Details

I. General information

NPI: 1114443900
Provider Name (Legal Business Name): HEIDI MARIE STEARNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 08/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 CENTENNIAL PLZ
EUGENE OR
97401-2421
US

IV. Provider business mailing address

86 U ST
SPRINGFIELD OR
97477-2154
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-6340
  • Fax:
Mailing address:
  • Phone: 541-406-9203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: