Provider Demographics
NPI:1851913800
Name:CALKINS, HEATHER MAE (PHD, LP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MAE
Last Name:CALKINS
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MAE
Other - Last Name:PRASSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2313 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1743
Mailing Address - Country:US
Mailing Address - Phone:308-381-8851
Mailing Address - Fax:308-381-8853
Practice Address - Street 1:3230 W WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-9609
Practice Address - Country:US
Practice Address - Phone:308-381-8851
Practice Address - Fax:308-381-8853
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5761101Y00000X
NE1116103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026522520Medicaid
NE10026522513Medicaid