Provider Demographics
NPI:1194366575
Name:BOXRUD, HEATHER LEE (MSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEE
Last Name:BOXRUD
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 1:204 E ELGIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2456
Mailing Address - Country:US
Mailing Address - Phone:170-192-8059
Mailing Address - Fax:
Practice Address - Street 1:623 DAHL RD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2782
Practice Address - Country:US
Practice Address - Phone:605-642-2777
Practice Address - Fax:605-642-9356
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)