Provider Demographics
NPI:1114211125
Name:CHAREST, HEATHER ALYSSA
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALYSSA
Last Name:CHAREST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 UNION ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1872
Mailing Address - Country:US
Mailing Address - Phone:781-429-7755
Mailing Address - Fax:
Practice Address - Street 1:15 UNION ST FL 2
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1872
Practice Address - Country:US
Practice Address - Phone:603-361-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker