Provider Demographics
NPI:1083656789
Name:CHEE, HEIDI KINNERSLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:KINNERSLEY
Last Name:CHEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5619 W 3575 S
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84128-2616
Mailing Address - Country:US
Mailing Address - Phone:801-272-5083
Mailing Address - Fax:801-272-5094
Practice Address - Street 1:2040 MURRAY HOLLADAY RD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5142
Practice Address - Country:US
Practice Address - Phone:801-256-1590
Practice Address - Fax:801-272-5094
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5204765-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical