Provider Demographics
NPI:1710518287
Name:HEINZ, DEANNA D (LMSW)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:D
Last Name:HEINZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:D
Other - Last Name:JURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:16931 19 MILE RD
Mailing Address - Street 2:STE 140
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4841
Mailing Address - Country:US
Mailing Address - Phone:586-226-2822
Mailing Address - Fax:586-226-2833
Practice Address - Street 1:16931 19 MILE RD STE 140
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4841
Practice Address - Country:US
Practice Address - Phone:586-226-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010709321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical