Provider Demographics
NPI:1083788129
Name:HEUSER, WILLARD E (LCSW, ICADC)
Entity Type:Individual
Prefix:MR
First Name:WILLARD
Middle Name:E
Last Name:HEUSER
Suffix:
Gender:M
Credentials:LCSW, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902A MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-4605
Mailing Address - Country:US
Mailing Address - Phone:302-655-7108
Mailing Address - Fax:302-655-0689
Practice Address - Street 1:1902-A MARYLAND AVE.
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-655-7108
Practice Address - Fax:302-655-0689
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE407101YA0400X
DEQ100004811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)