Provider Demographics
NPI:1083303259
Name:HEINZ, ABBY (LMSW)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:HEINZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2274 BISON ST APT D
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-4960
Mailing Address - Country:US
Mailing Address - Phone:319-530-3704
Mailing Address - Fax:
Practice Address - Street 1:2274 BISON ST APT D
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-4960
Practice Address - Country:US
Practice Address - Phone:319-530-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095435104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker