Provider Demographics
NPI:1093467276
Name:ADAMS, HEATHER (LMSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:CONCIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5440 W FRANKLIN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-6434
Mailing Address - Country:US
Mailing Address - Phone:208-793-0004
Mailing Address - Fax:
Practice Address - Street 1:5440 W FRANKLIN RD STE 201
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-6434
Practice Address - Country:US
Practice Address - Phone:208-793-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-39838101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health