Provider Demographics
NPI:1154941391
Name:SPRINGS, HEATHER ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:SPRINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELIZABETH
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW INTERN
Mailing Address - Street 1:PO BOX 1364
Mailing Address - Street 2:
Mailing Address - City:EL GRANADA
Mailing Address - State:CA
Mailing Address - Zip Code:94018-1364
Mailing Address - Country:US
Mailing Address - Phone:650-204-0611
Mailing Address - Fax:
Practice Address - Street 1:730 EL GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:EL GRANADA
Practice Address - State:CA
Practice Address - Zip Code:94018-8174
Practice Address - Country:US
Practice Address - Phone:650-204-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1011381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1477620821Medicaid