Provider Demographics
NPI:1083859920
Name:HOLZHAUSER, HEATHER RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:HOLZHAUSER
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 1:15605 W 154TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3481
Mailing Address - Country:US
Mailing Address - Phone:913-909-5318
Mailing Address - Fax:
Practice Address - Street 1:15605 W 154TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3481
Practice Address - Country:US
Practice Address - Phone:913-909-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490206851041C0700X
KS6296104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker