Provider Demographics
NPI:1942780127
Name:SPAAN, HEATHER M (LMSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:M
Last Name:SPAAN
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 1:111 ARIZONA AVE NW
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1425
Mailing Address - Country:US
Mailing Address - Phone:712-737-9444
Mailing Address - Fax:712-737-9445
Practice Address - Street 1:111 ARIZONA AVE NW
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1425
Practice Address - Country:US
Practice Address - Phone:712-737-9444
Practice Address - Fax:712-737-9445
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA091684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health