Provider Demographics
NPI:1225234198
Name:KASSNER, HEIDI LYN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LYN
Last Name:KASSNER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:LYN
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1563 N MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2983
Mailing Address - Country:US
Mailing Address - Phone:508-324-1060
Mailing Address - Fax:508-679-8590
Practice Address - Street 1:1563 N MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2983
Practice Address - Country:US
Practice Address - Phone:508-324-1060
Practice Address - Fax:508-679-8590
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2009-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG127871041C0700X
MA1152491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical