Provider Demographics
NPI:1891001004
Name:BURROUGHS, HEATHER ANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANNE
Last Name:BURROUGHS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 WINTER SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9347
Mailing Address - Country:US
Mailing Address - Phone:407-920-4759
Mailing Address - Fax:
Practice Address - Street 1:2040 WINTER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9347
Practice Address - Country:US
Practice Address - Phone:407-920-4759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2022-01-24
Deactivation Date:2013-10-08
Deactivation Code:
Reactivation Date:2015-01-28
Provider Licenses
StateLicense IDTaxonomies
FLSW 99361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical