Provider Demographics
NPI:1972619971
Name:PALISIN, HEATHER LEE (LISW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEE
Last Name:PALISIN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7271 CRAIGMERE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-5342
Mailing Address - Country:US
Mailing Address - Phone:440-891-1539
Mailing Address - Fax:
Practice Address - Street 1:7265 OLD OAK BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3342
Practice Address - Country:US
Practice Address - Phone:440-816-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00099891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical