Provider Demographics
NPI:1376928416
Name:ROSENHAMER, HEATHER RENAE (LMSW U/S)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENAE
Last Name:ROSENHAMER
Suffix:
Gender:F
Credentials:LMSW U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 W CADDO ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020-4201
Mailing Address - Country:US
Mailing Address - Phone:918-308-5511
Mailing Address - Fax:918-205-2701
Practice Address - Street 1:907 W CADDO ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OK
Practice Address - Zip Code:74020-4201
Practice Address - Country:US
Practice Address - Phone:918-308-5511
Practice Address - Fax:918-205-2701
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OK8986104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator