Provider Demographics
NPI:1831463769
Name:HEYD, WHITNEY LYN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:LYN
Last Name:HEYD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 KUWILI ST
Mailing Address - Street 2:ROOM 105
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5362
Mailing Address - Country:US
Mailing Address - Phone:808-532-6744
Mailing Address - Fax:808-532-6747
Practice Address - Street 1:414 KUWILI ST
Practice Address - Street 2:ROOM 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5362
Practice Address - Country:US
Practice Address - Phone:808-532-6744
Practice Address - Fax:808-532-6747
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI64643201Medicaid