Provider Demographics
NPI:1851077226
Name:METCALF, HEATHER ANNE I
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:METCALF
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 QUEENS BLVD APT 3G
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2889
Mailing Address - Country:US
Mailing Address - Phone:917-575-6615
Mailing Address - Fax:
Practice Address - Street 1:7 W 30TH ST FL 910
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4406
Practice Address - Country:US
Practice Address - Phone:212-785-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health