Provider Demographics
NPI:1942331632
Name:WOOD, HEATHER L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:L
Last Name:WOOD
Suffix:
Gender:F
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:PO BOX 3864
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-7864
Mailing Address - Country:US
Mailing Address - Phone:562-489-3090
Mailing Address - Fax:
Practice Address - Street 1:5132 E LIVINGSTON DR
Practice Address - Street 2:SUITE 8
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5545
Practice Address - Country:US
Practice Address - Phone:562-489-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker