Provider Demographics
NPI:1437169273
Name:HEYMANS, JAMES RICHARD (LICSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:HEYMANS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 CHIPPEWA CT N
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1529
Mailing Address - Country:US
Mailing Address - Phone:651-779-2383
Mailing Address - Fax:
Practice Address - Street 1:1360 ENERGY PARK DR
Practice Address - Street 2:SUITE 340
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-5276
Practice Address - Country:US
Practice Address - Phone:651-646-8985
Practice Address - Fax:651-646-3959
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical