Provider Demographics
NPI:1679878912
Name:PICKARD, HEATHER B (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:B
Last Name:PICKARD
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 GROVELAND COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:MA
Mailing Address - Zip Code:01834-1352
Mailing Address - Country:US
Mailing Address - Phone:508-577-7931
Mailing Address - Fax:
Practice Address - Street 1:391 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2119
Practice Address - Country:US
Practice Address - Phone:978-995-8596
Practice Address - Fax:978-322-5097
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1175141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical