MEDICARE: HEATHER MACH LPCC

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	2600	MN

General Provider Information

NPI Number	:	1952074544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MACH LPCC

Provider Business Mailing Address
First Line	:	1346 ONYX WAY NE
Second Line	:
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-4563
Country	:	US
Telephone Number	:	651-815-9405
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 MINNESOTA BLVD
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56304-2424
Country	:	US
Telephone Number	:	320-240-6872
Fax Number	:

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

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	07/29/2021

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Directions to “ HEATHER MACH LPCC” Practice Location

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