Provider Demographics
NPI:1003179375
Name:KERR, HEATHER GOULD (LCSW-C)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:GOULD
Last Name:KERR
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNN
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 SOUTH UNION AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078
Mailing Address - Country:US
Mailing Address - Phone:443-526-6133
Mailing Address - Fax:443-526-6134
Practice Address - Street 1:611 SOUTH UNION AVENUE
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078
Practice Address - Country:US
Practice Address - Phone:443-526-6133
Practice Address - Fax:443-526-6134
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD140051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical