Provider Demographics
NPI:1669737375
Name:HEIDI J. HADEN, LPC, LLC
Entity type:Organization
Organization Name:HEIDI J. HADEN, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:HADEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:520-709-1777
Mailing Address - Street 1:20987 N JOHN WAYNE PKWY
Mailing Address - Street 2:B104-353
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-2926
Mailing Address - Country:US
Mailing Address - Phone:520-709-1777
Mailing Address - Fax:
Practice Address - Street 1:19395 N JOHN WAYNE PKWY
Practice Address - Street 2:STE 4
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-2833
Practice Address - Country:US
Practice Address - Phone:520-709-1777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty