Provider Demographics
NPI:1891734695
Name:HEIKKILA, RICK A (LCSW)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:A
Last Name:HEIKKILA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 12TH AVE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5735
Mailing Address - Country:US
Mailing Address - Phone:208-466-2188
Mailing Address - Fax:208-466-2189
Practice Address - Street 1:924 12TH AVE RD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5735
Practice Address - Country:US
Practice Address - Phone:208-466-2188
Practice Address - Fax:208-466-2189
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW255021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical