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Linda Heaviside MS, LPC, NCC Licensed Professional Counselor National Certified CounselorClient Information Form This Form is Confidential Please complete and print this form. Bring it with you to
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Linda Heaviside is a licensed professional, possibly in a field such as psychology, counseling, or social work, who has met specific licensing requirements to practice in her profession.
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Information that must be reported may include personal identification details, licensing number, continuing education credits, and any disciplinary actions or complaints.
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