Provider Demographics
NPI:1013290568
Name:ASTILL, HEATHER ANNE (MSW, LSCSW, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANNE
Last Name:ASTILL
Suffix:
Gender:F
Credentials:MSW, LSCSW, LCSW-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:HATHAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6700 W 121ST ST STE 102
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2028
Mailing Address - Country:US
Mailing Address - Phone:202-681-4747
Mailing Address - Fax:
Practice Address - Street 1:6700 W 121ST ST STE 102
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2028
Practice Address - Country:US
Practice Address - Phone:202-681-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD220961041C0700X
KS50101041C0700X
WASC 60320593104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical