MALLORY DIANE HEISE (NPI# 1801358650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801358650 |
| Entity Type | Individual |
| Full Name | MALLORY DIANE HEISE |
| Credential | LAC |
| Practice Address |
220 Ruskin Dr Colorado Springs CO 80910-2522 |
| Practice Telephone | 7193144277 |
| Mailing Telephone | 7193144277 |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
220 RUSKIN DR |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871594051 | Christina Lodell Bammes | Psychiatry & Neurology | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2005-08-10 |
| 1285268615 | Jessica Floria | Social Worker | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2020-02-25 |
| 1427693902 | Aspenpointe Inc. Dba Aspenpointe Health Services | Clinic/Center | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2019-11-08 |
| 1952832537 | Vernon T Mccord | Social Worker | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2017-03-24 |
| 1376080317 | Amanda Ortega | Registered Nurse | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2017-01-29 |
| 1952851974 | Margaret Ann Marshall | Registered Nurse | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2016-10-13 |
| 1750736385 | Iliana Caraveo | Counselor | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2016-05-02 |
| 1245685494 | Ashley Fish | Registered Nurse | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2016-04-25 |
| 1871956250 | Jennifer Ivan | Counselor | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2016-04-01 |
| 1518325018 | Emily L Maney | Social Worker | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2016-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955403 | Marian Lin Mondy | Social Worker | 2909 Wellshire Blvd., Colorado Springs, CO 80910 | 2019-08-01 |
| 1538727474 | Lisa Morales | Audiologist | 3225 International Cir Ste 102, Colorado Springs, CO 80910 | 2019-06-05 |
| 1134617038 | Paul Gross | Counselor | 411 Lakewood Circle Dr, C-204-b, Colorado Springs, CO 80910 | 2018-04-25 |
| 1821502923 | Kathleen Lubos Ambros-dahilig | Dental Assistant | 2240 Gilpin Ave, Colorado Springs, CO 80910 | 2017-11-28 |
| 1508384793 | Shawn Maul | Registered Nurse | 115 S Parkside, Colorado Springs, CO 80910 | 2017-09-07 |
| 1376910521 | Kelley Elizabeth Smith Bouchard | Nurse Practitioner | 3225 International Circle Suite 220, Colorado Springs, CO 80910 | 2015-08-24 |
| 1619353430 | Dr. Steven Alan Gould Dds PC | Dentist | 2859 E. Fountain Blvd, Colorado Springs, CO 80910 | 2015-08-04 |
| 1881029155 | Francis Hammet | Chiropractor | 411 Lakewood Circle A1104, Colorado Springs, CO 80910 | 2013-09-05 |
| 1447697586 | Mcb Clinical Research Centers, LLC | Psychologist | 110 S. Parkside Drive, Colorado Springs, CO 80910 | 2013-05-30 |
| 1417206723 | Augustus Albert Edwards | Case Manager/Care Coordinator | 115 Parkside Drive, Colorado Springs, CO 80910 | 2012-08-31 |
| Find all providers in zip 80910 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808914 | Pamela Weisman | Counselor | 125 N Parkside Dr Ste 202, Colorado Springs, CO 80909-6097 | 2020-07-13 |
| 1942837695 | Laurie Robertson | Counselor | 4564 Laramie Sky Dr, Colorado Springs, CO 80922-2231 | 2020-03-24 |
| 1316598063 | Affinity Therapy Services LLC | Counselor | 2950 Professional Pl Ste 115, Colorado Springs, CO 80904-8106 | 2019-09-24 |
| 1982269338 | Rachel Nicole Jenkins | Counselor | 1026 Maxwell St, Colorado Springs, CO 80906-5554 | 2019-05-01 |
| 1043874480 | Lauren Atencio | Counselor | 2270 La Montana Way Ste 200, Colorado Springs, CO 80918-6735 | 2019-04-30 |
| 1205319787 | Emily Ingram | Counselor | 2226 Golden Gate Grv, Colorado Springs, CO 80918-9400 | 2018-09-11 |
| 1326521246 | Jennifer Routt | Counselor | 803 N Wahsatch Ave Apt 2, Colorado Springs, CO 80903-2966 | 2018-09-07 |
| 1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
| 1003392408 | Brittany Edmondson | Counselor | 1619 Monterey Rd Apt D, Colorado Springs, CO 80910-4435 | 2018-07-18 |
| 1659867836 | Lisa Hoeffner | Counselor | 6165 Lehman Dr Ste 209, Colorado Springs, CO 80918-5406 | 2018-07-10 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
Please comment or provide details below to improve the information on MALLORY DIANE HEISE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.