Individual
HEATHER ITES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC, LADC
Contact information
Practice address
900 LONG LAKE RD STE 160, NEW BRIGHTON, MN 55112-6414
(612) 706-9630
Mailing address
69 HATCH AVE, SAINT PAUL, MN 55117-4938
(612) 806-1132
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304983
MN
101YM0800X
Mental Health Counselor
Primary
2686
MN
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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