Provider Demographics
NPI:1710129382
Name:CHRISTENSEN, HEATHER ANN (LSCW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 ANDERSON AVE
Mailing Address - Street 2:#36
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-1777
Mailing Address - Country:US
Mailing Address - Phone:201-527-5305
Mailing Address - Fax:
Practice Address - Street 1:1241 ANDERSON AVE
Practice Address - Street 2:#36
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-1777
Practice Address - Country:US
Practice Address - Phone:201-527-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050618001041C0700X
NY074861-11041C0700X
NY055543-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical