Provider Demographics
NPI:1275013484
Name:RORVICK, HEATHER ANNE (MS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:RORVICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:BRENDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 462
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-0462
Mailing Address - Country:US
Mailing Address - Phone:605-886-4300
Mailing Address - Fax:
Practice Address - Street 1:801 JENSON AVE SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-5257
Practice Address - Country:US
Practice Address - Phone:605-886-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD20762101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health