Provider Demographics
NPI:1942410915
Name:LITKE, HEATHER DARLENE (LPCC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:DARLENE
Last Name:LITKE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:DARLENE
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:MONTE RIO
Mailing Address - State:CA
Mailing Address - Zip Code:95462-0524
Mailing Address - Country:US
Mailing Address - Phone:925-708-0278
Mailing Address - Fax:
Practice Address - Street 1:19100 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MONTE RIO
Practice Address - State:CA
Practice Address - Zip Code:95462-9726
Practice Address - Country:US
Practice Address - Phone:925-708-0278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62922101YP2500X
CA254101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7833LCOtherBLUE CROSS BLUE SHIELD
TX184121501Medicaid