Provider Demographics
NPI:1235534967
Name:CRAVEN, HEATHER (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 REVOLUTION MILL DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5178
Mailing Address - Country:US
Mailing Address - Phone:336-334-5773
Mailing Address - Fax:
Practice Address - Street 1:925 REVOLUTION MILL DR
Practice Address - Street 2:SUITE 7
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5178
Practice Address - Country:US
Practice Address - Phone:336-334-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0070561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical