Provider Demographics
NPI:1710191887
Name:HEISLER, KATHARINE M (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:M
Last Name:HEISLER
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 1004
Mailing Address - Street 2:
Mailing Address - City:BUCKINGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:18912-1004
Mailing Address - Country:US
Mailing Address - Phone:267-261-6765
Mailing Address - Fax:
Practice Address - Street 1:4641 SANDS WAY
Practice Address - Street 2:
Practice Address - City:BUCKINGHAM
Practice Address - State:PA
Practice Address - Zip Code:18912-1004
Practice Address - Country:US
Practice Address - Phone:261-265-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005737001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical