Provider Demographics
NPI:1770921918
Name:MALINSKI, HEATHER LYN (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYN
Last Name:MALINSKI
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:LYN
Other - Last Name:MALONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:7983 LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:BURTCHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48059-1634
Mailing Address - Country:US
Mailing Address - Phone:810-962-6789
Mailing Address - Fax:
Practice Address - Street 1:1042 GRISWOLD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5867
Practice Address - Country:US
Practice Address - Phone:810-962-6789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010943031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical