Provider Demographics
NPI:1639566359
Name:KIEL, HEATHER (LMSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KIEL
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 1:450 MEADOW RUN DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-9053
Mailing Address - Country:US
Mailing Address - Phone:616-891-8770
Mailing Address - Fax:
Practice Address - Street 1:450 MEADOW RUN DR
Practice Address - Street 2:SUITE 300
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-9053
Practice Address - Country:US
Practice Address - Phone:616-891-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010934801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical