Provider Demographics
NPI:1205483211
Name:ALLEN, HEATHER (LCSW, CST)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LCSW, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 N GRANT ST SUITE 5B
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3262
Mailing Address - Country:US
Mailing Address - Phone:501-300-2812
Mailing Address - Fax:501-600-4336
Practice Address - Street 1:811 N GRANT ST SUITE 5B
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3262
Practice Address - Country:US
Practice Address - Phone:501-300-2812
Practice Address - Fax:501-600-4336
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8944-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical