Heidi Leckner

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1093-10-15-20-500 Issued in ND

Practice address

102 W Beaton Dr Ste 100
West Fargo, ND 58078-2652

Phone

(701) 347-1648

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Heidi Ottmar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Realational Therapy Services

  • Professional Counselor
  • West Fargo, ND
  • NPI 1033949128
  NPD Authorized official
• Southeast Behavioral Health Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fargo, ND
  • NPI 1932146941
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1225643125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3846 12TH ST W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788164",
            "telephone_number": "701-260-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W BEATON DR STE 100",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782652",
            "telephone_number": "701-347-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECKNER",
        "first_name": "HEIDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1093-10-15-20-500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "OTTMAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.