Provider Demographics
NPI:1053755025
Name:GORR, HEATHER LYNN (LPC, NCC, CJSOTS,)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:LYNN
Last Name:GORR
Suffix:
Gender:F
Credentials:LPC, NCC, CJSOTS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DRIVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4374
Mailing Address - Country:US
Mailing Address - Phone:512-713-1734
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DRIVE SUITE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4374
Practice Address - Country:US
Practice Address - Phone:512-713-1734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2023-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008555101YM0800X, 101YP2500X
TX88514101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100777740-0083Medicaid