Heather Ballingham

Individual provider Active NPI Mental Health Counselor · Providence, UT

NPI 1104368182 · NPPES record last updated Nov 8, 2016

Key facts

NPI
1104368182
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
10121291-6009 (UT)
Practice address
277 N Spring Creek Pkwy
Providence, UT 84332-9775
Phone
(435) 753-0253
NPI assigned
Nov 8, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10121291-6009UTMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10121291-6009 UT Yes

Addresses

Primary practice location

277 N Spring Creek Pkwy
Providence, UT 84332-9775

Mailing address

277 N Spring Creek Pkwy
Providence, UT 84332-9775
Phone (435) 753-0253

Other providers in Providence, UT

All providers in Providence, UT · Mental Health Counselor in Utah

Sources for this page

Verify at the official NPI Registry.