Individual
HEIDI L SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LPC
Contact information
Practice address
125 E JAMES DR, SIERRA VISTA, AZ 85635-1156
(469) 955-6579
Mailing address
125 E JAMES DR, SIERRA VISTA, AZ 85635-1156
(469) 955-6579
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
65482
TX
101YM0800X
Mental Health Counselor
65482
TX
101YP2500X
Professional Counselor
Primary
19369
AZ
101YP2500X
Professional Counselor
65482
TX
103T00000X
Psychologist
65482
TX
103TC1900X
Counseling Psychologist
65482
TX
171M00000X
Case Manager/Care Coordinator
65482
TX
Other
Enumeration date
04/28/2011
Last updated
03/25/2025
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