Provider Demographics
NPI:1396062436
Name:TRUMBLE, HEIDI (LCSW)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:TRUMBLE
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 1:7939 SW 163RD ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-8690
Mailing Address - Country:US
Mailing Address - Phone:360-899-8577
Mailing Address - Fax:316-465-0907
Practice Address - Street 1:7939 SW 163RD ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-8690
Practice Address - Country:US
Practice Address - Phone:360-899-8577
Practice Address - Fax:316-465-0907
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW67921041C0700X
KS061361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical