Provider Demographics
NPI:1609100403
Name:OLDS, HEATHER L (MSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:OLDS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:7775 HARRISBURG LONDON RD
Mailing Address - Street 2:
Mailing Address - City:ORIENT
Mailing Address - State:OH
Mailing Address - Zip Code:43146-9416
Mailing Address - Country:US
Mailing Address - Phone:208-699-3651
Mailing Address - Fax:
Practice Address - Street 1:420 N JAMES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1834
Practice Address - Country:US
Practice Address - Phone:208-699-3651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-324041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical