Provider Demographics
NPI:1134331739
Name:HEIDI STRATER LCSW PA
Entity Type:Organization
Organization Name:HEIDI STRATER LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:NELL
Authorized Official - Last Name:STRATER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-470-7119
Mailing Address - Street 1:8373 VIA SERENA
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2240
Mailing Address - Country:US
Mailing Address - Phone:561-470-7119
Mailing Address - Fax:561-487-6546
Practice Address - Street 1:8020 W ATLANTIC AVE BLDG 1
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-9713
Practice Address - Country:US
Practice Address - Phone:561-637-2472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW56771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ024TOtherBC.BS
FLE7388Medicare ID - Type Unspecified