Provider Demographics
NPI:1427595602
Name:SEGER, HEATHER (LICSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SEGER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COLLEGE HILL RD FL 2
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2745
Mailing Address - Country:US
Mailing Address - Phone:401-250-2591
Mailing Address - Fax:401-528-0124
Practice Address - Street 1:21 COLLEGE HILL RD FL 2
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2745
Practice Address - Country:US
Practice Address - Phone:401-250-2591
Practice Address - Fax:401-528-0124
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
RIISW027951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor