Provider Demographics
NPI:1295960573
Name:THORPE, HEATHER HOWARD (LCSW-R)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:HOWARD
Last Name:THORPE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:D
Other - Last Name:REDMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:223 HARVARD RD
Mailing Address - Street 2:
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-7307
Mailing Address - Country:US
Mailing Address - Phone:908-217-4152
Mailing Address - Fax:814-317-0341
Practice Address - Street 1:401 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3854
Practice Address - Country:US
Practice Address - Phone:518-431-1650
Practice Address - Fax:518-426-2835
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0162731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical