Provider Demographics
NPI:1922595149
Name:COLLIER, HEIDI (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27625 US HIGHWAY 98 BLDG A
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4816
Mailing Address - Country:US
Mailing Address - Phone:334-456-8809
Mailing Address - Fax:251-929-4213
Practice Address - Street 1:27625 US HIGHWAY 98 BLDG A
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4816
Practice Address - Country:US
Practice Address - Phone:334-456-8809
Practice Address - Fax:251-929-4213
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AL4639C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker