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General NPI Number Information
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NPI Number | 1417976556
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Entity Type | Individual
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Provider Name | HEIDI JOAN LETKO LPC, LAC, QMHP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 12/28/2019
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Provider Practice Location Address
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Address Line | 3955 E EXPOSITION AVE STE 206
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City | DENVER
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State | CO
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Zip | 80209-5032
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Country | US
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Telephone | 720-617-7700
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Fax | 720-617-7800
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Provider Business Mailing Address
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Address Line | 10240 NW VILLAGE HEIGHTS DR
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City | PORTLAND
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State | OR
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Zip | 97229-7591
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Country | US
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Telephone | 971-244-8368
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C2107
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License Number State | OR
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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 | C2107
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License Number State | OR
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