Provider Demographics
NPI:1164400032
Name:PAGE, HEIDI L (MSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:PAGE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TREMONT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4465
Mailing Address - Country:US
Mailing Address - Phone:603-716-1282
Mailing Address - Fax:
Practice Address - Street 1:1 TREMONT ST STE 2
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4465
Practice Address - Country:US
Practice Address - Phone:603-716-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHPA RE5759Medicare ID - Type UnspecifiedMEDICARE IDENIFICATION NO