Provider Demographics
NPI:1184616229
Name:BIRD, HEATHER LEAH (LCSW LMHP LADC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEAH
Last Name:BIRD
Suffix:
Gender:F
Credentials:LCSW LMHP LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15444 DOUGLAS CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2052
Mailing Address - Country:US
Mailing Address - Phone:402-965-9881
Mailing Address - Fax:
Practice Address - Street 1:2101 S 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2947
Practice Address - Country:US
Practice Address - Phone:402-552-7458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NELMHP-2661101YM0800X
NECMSW-1094104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker