Provider Demographics
NPI:1083625503
Name:LEFFLER, HEIDI (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:LEFFLER
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 GRAVIER ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2269
Mailing Address - Country:US
Mailing Address - Phone:504-412-1819
Mailing Address - Fax:
Practice Address - Street 1:2025 GRAVIER ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2269
Practice Address - Country:US
Practice Address - Phone:504-412-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA24441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1993034Medicaid
LA800007936Medicare PIN
LA5S443Medicare PIN
LA5S443F669Medicare PIN
LA1993034Medicaid