Provider Demographics
NPI:1093017444
Name:PRICE, HEATHER N (ACSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:N
Last Name:PRICE
Suffix:
Gender:F
Credentials:ACSW, LISW-S
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:N
Other - Last Name:THACKSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW, LISW-S
Mailing Address - Street 1:3333 BURNET AVENUE
Mailing Address - Street 2:MLC 3014
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4788
Mailing Address - Fax:513-636-4283
Practice Address - Street 1:3333 BURNET AVENUE
Practice Address - Street 2:MLC 3014
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4788
Practice Address - Fax:513-636-4283
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.10009081041C0700X
OHI.1201521.SUPV1041C0700X
OHI.1201521-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical