Provider Demographics
NPI:1356882666
Name:HESTON, HOLLY ANN (LCSW)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:HESTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LEXINGTON CT
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5456
Mailing Address - Country:US
Mailing Address - Phone:732-337-4038
Mailing Address - Fax:
Practice Address - Street 1:530 PROSPECT AVE
Practice Address - Street 2:UNIT C
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1444
Practice Address - Country:US
Practice Address - Phone:732-337-4038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057223001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical