Provider Demographics
NPI:1962858274
Name:SPERA, HEATHER (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SPERA
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 COROLLA CIR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-7904
Mailing Address - Country:US
Mailing Address - Phone:859-494-2388
Mailing Address - Fax:
Practice Address - Street 1:7000 HOUSTON RD
Practice Address - Street 2:BUILDING 200 STE 18
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4873
Practice Address - Country:US
Practice Address - Phone:859-525-0185
Practice Address - Fax:859-525-8100
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical