Provider Demographics
NPI:1467028696
Name:COMPTON, HEIDI SUZANNE (MSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:SUZANNE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 FAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:WESTOVER
Mailing Address - State:WV
Mailing Address - Zip Code:26501-0087
Mailing Address - Country:US
Mailing Address - Phone:304-292-1716
Mailing Address - Fax:
Practice Address - Street 1:827 FAIRMONT RD
Practice Address - Street 2:
Practice Address - City:WESTOVER
Practice Address - State:WV
Practice Address - Zip Code:26501-0087
Practice Address - Country:US
Practice Address - Phone:304-292-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00941293104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker