Healthcare Provider Details

I. General information

NPI: 1215864459
Provider Name (Legal Business Name): HEATHER ROLAND MA, LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18811 53RD STREET CT E
LAKE TAPPS WA
98391-8982
US

IV. Provider business mailing address

18811 53RD STREET CT E STE 103
LAKE TAPPS WA
98391-8982
US

V. Phone/Fax

Practice location:
  • Phone: 206-414-8780
  • Fax: 253-390-3033
Mailing address:
  • Phone: 206-414-8780
  • Fax: 253-390-3033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70005261
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: