Healthcare Provider Details

I. General information

NPI: 1215663067
Provider Name (Legal Business Name): HEIDI VAN SCHOONHOVEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 WASHINGTON AVE
LA GRANDE OR
97850-2533
US

IV. Provider business mailing address

1119 WASHINGTON AVE
LA GRANDE OR
97850-2533
US

V. Phone/Fax

Practice location:
  • Phone: 541-805-2878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC8294
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: