Provider Demographics
NPI:1871144352
Name:VANI, HEATHER SARA (LMHC, BC-TMH)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SARA
Last Name:VANI
Suffix:
Gender:F
Credentials:LMHC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 BALDWIN PATH
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1417
Mailing Address - Country:US
Mailing Address - Phone:516-592-3132
Mailing Address - Fax:
Practice Address - Street 1:600 HEMPSTEAD TPKE STE 120
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1036
Practice Address - Country:US
Practice Address - Phone:516-592-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health