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General NPI Number Information
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NPI Number | 1003939257
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Entity Type | Individual
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Provider Name | SUSAN M HEUMILLER LPC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 2960 RODEO PARK DR W
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City | SANTA FE
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State | NM
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Zip | 87505-6351
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Country | US
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Telephone | 505-986-9633
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Fax | 505-820-1209
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Provider Business Mailing Address
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Address Line | 2960 RODEO PARK DR W
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City | SANTA FE
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State | NM
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Zip | 87505-6351
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Country | US
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Telephone | 505-986-9633
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Fax | 505-820-1209
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC004129
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0115081
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00294300
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License Number State | NJ
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