Provider Demographics
NPI:1679901573
Name:CALKINS, JUDITH HEAVEY (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:HEAVEY
Last Name:CALKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:OR
Mailing Address - Zip Code:97882-0157
Mailing Address - Country:US
Mailing Address - Phone:541-922-7379
Mailing Address - Fax:
Practice Address - Street 1:485 W LOCUST AVE
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1736
Practice Address - Country:US
Practice Address - Phone:541-922-7379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical