Provider Demographics
NPI:1205228756
Name:HEENAN, RACHEL (LICSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HEENAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HERBIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33301 1ST WAY S STE C115
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4553
Mailing Address - Country:US
Mailing Address - Phone:253-332-4324
Mailing Address - Fax:
Practice Address - Street 1:33301 1ST WAY S STE C115
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4553
Practice Address - Country:US
Practice Address - Phone:253-332-4324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW604365991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical