Provider Demographics
NPI:1003487174
Name:KINDSCHY, HEATHER LYNN (LCSW-BACS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:KINDSCHY
Suffix:
Gender:F
Credentials:LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 W PIERRE LN
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1532
Mailing Address - Country:US
Mailing Address - Phone:262-339-3367
Mailing Address - Fax:
Practice Address - Street 1:14755 W CAPITOL DR STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2318
Practice Address - Country:US
Practice Address - Phone:262-781-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA102961041C0700X
WI11623-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical