MEDICARE: HEATHER HARBACHUK CADC-I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	07827-I	NV

General Provider Information

NPI Number	:	1609753359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER HARBACHUK CADC-I

Provider Business Mailing Address
First Line	:	9350 S CIMARRON RD UNIT 1031
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-2513
Country	:	US
Telephone Number	:	732-261-4124
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 S BRONCO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5208
Country	:	US
Telephone Number	:	702-625-3972
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	08/16/2025

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