Provider Demographics
NPI:1518320530
Name:SEYMOUR, HEATHER PEARSON (LSW, MSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:PEARSON
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 E LONGVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3923
Mailing Address - Country:US
Mailing Address - Phone:207-837-3920
Mailing Address - Fax:
Practice Address - Street 1:808 E LONGVIEW AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3923
Practice Address - Country:US
Practice Address - Phone:207-837-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16000201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical