Provider Demographics
NPI:1811515513
Name:ACHATZ, HEATH H (LLMSW)
Entity type:Individual
Prefix:MR
First Name:HEATH
Middle Name:H
Last Name:ACHATZ
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SAINT CLAIR RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ALGONAC
Mailing Address - State:MI
Mailing Address - Zip Code:48001-1802
Mailing Address - Country:US
Mailing Address - Phone:810-794-4917
Mailing Address - Fax:810-794-7645
Practice Address - Street 1:555 SAINT CLAIR RIVER DR
Practice Address - Street 2:
Practice Address - City:ALGONAC
Practice Address - State:MI
Practice Address - Zip Code:48001-1802
Practice Address - Country:US
Practice Address - Phone:810-794-4917
Practice Address - Fax:810-794-7645
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801102282104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker