Provider Demographics
NPI:1578045977
Name:ARB, HEAVEN MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:HEAVEN
Middle Name:MARIE
Last Name:ARB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:KS
Mailing Address - Zip Code:66835-9657
Mailing Address - Country:US
Mailing Address - Phone:620-794-6369
Mailing Address - Fax:
Practice Address - Street 1:1420 C OF E DR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2556
Practice Address - Country:US
Practice Address - Phone:785-709-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11057104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker