Provider Demographics
NPI:1497234397
Name:MEISTER, HEIDI LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYNN
Last Name:MEISTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864 GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2823
Mailing Address - Country:US
Mailing Address - Phone:847-322-5592
Mailing Address - Fax:
Practice Address - Street 1:1060 E LAKE ST STE 201A
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-5400
Practice Address - Country:US
Practice Address - Phone:847-322-5592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-10
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490037941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1497234937Medicaid