Provider Demographics
NPI:1407207657
Name:HOWARD, HEATHER (LCSWA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 STUART AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-3051
Mailing Address - Country:US
Mailing Address - Phone:910-918-1378
Mailing Address - Fax:
Practice Address - Street 1:10 REFERENDUM DR NE
Practice Address - Street 2:
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-7579
Practice Address - Country:US
Practice Address - Phone:910-253-5801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0120601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical