Provider Demographics
NPI:1942458435
Name:HARTER, HEATHER LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:HARTER
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 1:4028 SPRINGHILL ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISIVLLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-387-2499
Mailing Address - Fax:
Practice Address - Street 1:214 BRECKENRIDGE LANE
Practice Address - Street 2:114
Practice Address - City:LOUISIVLLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-387-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005544A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical