Heidi Carmody

Primary specialty

CounselorTaxonomy code 101Y00000X

License

SA61032041 Issued in WA

Practice address

831 12TH Ave
Longview, WA 98632-2403

Phone

(360) 998-2349

Fax

(360) 998-2887

NPI assigned

Jan 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Heidi Patten Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1376173187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7729 NE QUARRY RD",
            "city": "LA CENTER",
            "state": "WA",
            "postal_code": "986295221",
            "telephone_number": "360-431-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 12TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322403",
            "telephone_number": "360-998-2349",
            "fax_number": "360-998-2887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1057 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322509",
            "country_code": "US",
            "telephone_number": "360-261-7848",
            "fax_number": "360-232-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMODY",
        "first_name": "HEIDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "SA61032041",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SA61032041",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "SA61032041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "PATTEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tina Louise Canizal Marchand
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• Gregory Cantwell, RPH
• William E Caras, M.D.
• Care Medical Equipment, Inc.
• Joan Casciato Carpenter, M.A, CCC-SLP
• Melody D Carr, BA, AAC
• Carlos R Carreon, MSW
• Leena Carriere, D.O.
• Susan Diane Carriker

• Counselor in Longview, WA
• Providers in Longview, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.