Provider Demographics
NPI:1689616443
Name:MCPIKE, HEATHER R (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:MCPIKE
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 1:700 MOUNT HOPE AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5664
Mailing Address - Country:US
Mailing Address - Phone:207-941-2952
Mailing Address - Fax:207-873-6612
Practice Address - Street 1:24 SPRINGER RD SUITE 202
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-992-2535
Practice Address - Fax:207-992-2539
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC133031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical