Provider Demographics
NPI:1225045644
Name:CROSIER, HEIDI (MSW)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:CROSIER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:CROSIER-SYPITKOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:6 STATE ST STE 606
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5140
Mailing Address - Country:US
Mailing Address - Phone:207-945-9820
Mailing Address - Fax:
Practice Address - Street 1:6 STATE ST STE 606
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5140
Practice Address - Country:US
Practice Address - Phone:207-945-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC000024081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9167Medicare ID - Type UnspecifiedMEDICARE NUMBER