MEDICARE: MISS CHLOE HEBERLEIN TLMHC

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	101YM0800X	Mental Health Counselor	109689	IA

General Provider Information

NPI Number	:	1851061162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHLOE HEBERLEIN TLMHC

Provider Business Mailing Address
First Line	:	210 JONES ST STE 212
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-7615
Country	:	US
Telephone Number	:	563-241-5566
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 JONES ST STE 212
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-7615
Country	:	US
Telephone Number	:	563-241-5566
Fax Number	:

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

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	09/15/2022

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