Provider Demographics
NPI:1508077660
Name:HEALY, HEATHER GEDDES (LCSW-C, CEAP, SAP,)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:GEDDES
Last Name:HEALY
Suffix:
Gender:F
Credentials:LCSW-C, CEAP, SAP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15204 WILD ROSE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1765
Mailing Address - Country:US
Mailing Address - Phone:301-437-0390
Mailing Address - Fax:301-929-3102
Practice Address - Street 1:15204 WILD ROSE LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-1765
Practice Address - Country:US
Practice Address - Phone:301-437-0390
Practice Address - Fax:301-929-3102
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD51501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical