Provider Demographics
NPI:1205945474
Name:HOLCOMB, HEATHER LYNN (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 E 22ND ST N STE 100-2
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2301
Mailing Address - Country:US
Mailing Address - Phone:316-300-5787
Mailing Address - Fax:316-999-0610
Practice Address - Street 1:8100 E 22ND ST N STE 100-2
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2301
Practice Address - Country:US
Practice Address - Phone:316-686-5195
Practice Address - Fax:316-686-8714
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2259-LSCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical