Provider Demographics
NPI:1407834765
Name:SPIEGEL (FERSTL), HEIDI (MSW, LISW)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:SPIEGEL (FERSTL)
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 PARAGON RD UNIT 750031
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45475-5003
Mailing Address - Country:US
Mailing Address - Phone:937-503-7171
Mailing Address - Fax:
Practice Address - Street 1:2591 MIAMISBURG CENTERVILLE RD STE 301
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3706
Practice Address - Country:US
Practice Address - Phone:614-459-4490
Practice Address - Fax:937-949-7700
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0009032101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health