Provider Demographics
NPI:1023760576
Name:SMITH, HEATHER SUE (MSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:SUE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 HERITAGE HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-0104
Mailing Address - Country:US
Mailing Address - Phone:515-344-1593
Mailing Address - Fax:
Practice Address - Street 1:7001 N ROXBURY MILL RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22551-2441
Practice Address - Country:US
Practice Address - Phone:540-582-7617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool