Provider Demographics
NPI:1417146986
Name:ZELAYA, HEATHER GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GAIL
Last Name:ZELAYA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:GAIL
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2900 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-3800
Mailing Address - Country:US
Mailing Address - Phone:816-516-7114
Mailing Address - Fax:816-761-1899
Practice Address - Street 1:301 S 24TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1116
Practice Address - Country:US
Practice Address - Phone:479-636-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6737-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical