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General NPI Number Information
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NPI Number | 1467996934
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Entity Type | Individual
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Provider Name | RAIZEL HEITZER MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/18/2016
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 2210 E LA SALLE ST STE 207
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2358
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Country | US
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Telephone | 719-301-0136
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Fax |
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Provider Business Mailing Address
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Address Line | 1327 E PARKWAY DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80905-7393
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Country | US
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Telephone | 720-320-4114
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CO0005374
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License Number State | CO
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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 | 6401015253
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License Number State | MI
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