Provider Demographics
NPI:1922582923
Name:LANDING, HEVYLLA (LMSW)
Entity Type:Individual
Prefix:
First Name:HEVYLLA
Middle Name:
Last Name:LANDING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 MELODY DR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3644
Mailing Address - Country:US
Mailing Address - Phone:910-299-2094
Mailing Address - Fax:843-278-9198
Practice Address - Street 1:149 RIVERWALK BLVD STE 11
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-8191
Practice Address - Country:US
Practice Address - Phone:843-636-5017
Practice Address - Fax:843-278-9198
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12601104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker