Provider Demographics
NPI:1447892534
Name:NATALIE HEIDTMANN, LPC, MS, CADCI, LLC
Entity type:Organization
Organization Name:NATALIE HEIDTMANN, LPC, MS, CADCI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEIDTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MS, CADCI
Authorized Official - Phone:541-318-6232
Mailing Address - Street 1:20233 SUNDOWNER LN
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1152
Mailing Address - Country:US
Mailing Address - Phone:541-248-1577
Mailing Address - Fax:541-639-4361
Practice Address - Street 1:1001 SW DISK DR STE 110
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2946
Practice Address - Country:US
Practice Address - Phone:541-248-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty