Active NPI
Paula Marie Von Der Heide, LAPC
- Mental Health Counselor
- Valdosta, GA
National Provider Identifier
1609963602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1017
- Practice address
- 206 S Patterson St
Valdosta, GA 31601-5668 - Phone
- (229) 245-2373
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1017 | GA | Primary |
Addresses
Primary practice location
206 S Patterson St
Valdosta, GA 31601-5668
Mailing address
1018 Hillside Dr
Valdosta, GA 31601-4309
Phone (229) 245-2373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1017 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609963602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1018 HILLSIDE DR",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316014309",
"telephone_number": "229-245-2373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 S PATTERSON ST",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316015668",
"telephone_number": "229-245-2373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VON DER HEIDE",
"first_name": "PAULA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LAPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "1017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.