Heather Ites, LPCC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2686 Issued in MN

Practice address

900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414

Phone

(612) 706-9630

NPI assigned

Aug 11, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Heather Brovold Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Health and Wellness Collaborative

  • Clinical Psychologist
  • New Brighton, MN
  • NPI 1548822943

  Multi-Specialty

  NPD
• Medical Care Services, PA

  • Family Medicine Physician
  • New Brighton, MN
  • NPI 1083778708

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1437824539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 HATCH AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551174938",
            "telephone_number": "612-806-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITES",
        "first_name": "HEATHER",
        "credential": "LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304983",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "BROVOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Isd 621
• Abdirisak Ismail
• Ruqiya Yusuf Isse, RN
• Susan Ivancie
• Andrea Lauren Iyegha, MA, LICSW
• Jacob Services LLC
• Elizabeth Jacobson
• Hossein A Jalali, D.D.S

• Mental Health Counselor in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.