MEDICARE: ELISABETH HEINER, PSYD, PLLC

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

General Provider Information

NPI Number	:	1912864026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELISABETH HEINER, PSYD, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 628
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-0628
Country	:	US
Telephone Number	:	360-301-1381
Fax Number	:	360-252-9078

Provider Business Practice Location Address
First Line	:	1111 FRANKLIN ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-6638
Country	:	US
Telephone Number	:	360-301-1381
Fax Number	:	360-252-9078

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. ELISABETH HEINER
Credential	:	PSYD, LMHC
Telephone Number	:	360-301-1381

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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