Provider Demographics
NPI:1871851139
Name:JOHNS, HEATHER MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:JOHNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:TOVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8371
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-1371
Mailing Address - Country:US
Mailing Address - Phone:406-212-3873
Mailing Address - Fax:
Practice Address - Street 1:307 1ST AVE E STE 13
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4965
Practice Address - Country:US
Practice Address - Phone:406-212-3873
Practice Address - Fax:406-212-3873
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical