Provider Demographics
NPI:1003106790
Name:LINDA HEINS, LCSW, LLC
Entity Type:Organization
Organization Name:LINDA HEINS, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-653-5205
Mailing Address - Street 1:10001 SE SUNNYSIDE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9804
Mailing Address - Country:US
Mailing Address - Phone:503-653-5205
Mailing Address - Fax:503-653-5219
Practice Address - Street 1:10001 SE SUNNYSIDE RD STE 140
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9804
Practice Address - Country:US
Practice Address - Phone:503-653-5205
Practice Address - Fax:503-653-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL18001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty