Provider Demographics
NPI:1770815847
Name:KIRWAN, HEIDI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:KIRWAN
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 1:60 PERSEVERANCE WAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1843
Mailing Address - Country:US
Mailing Address - Phone:508-771-3156
Mailing Address - Fax:508-771-3287
Practice Address - Street 1:60 PERSEVERANCE WAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1843
Practice Address - Country:US
Practice Address - Phone:508-771-3156
Practice Address - Fax:508-771-3287
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215178104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker