Provider Demographics
NPI:1780851352
Name:HEINISCH, CAROL ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:HEINISCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:HEINISCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3028 S AKRON CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-6419
Mailing Address - Country:US
Mailing Address - Phone:720-748-0117
Mailing Address - Fax:
Practice Address - Street 1:427 E BAYAUD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1803
Practice Address - Country:US
Practice Address - Phone:720-748-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical