Provider Demographics
NPI:1881411015
Name:FEIKEMA, HEATHER KAY (LGSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KAY
Last Name:FEIKEMA
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 MARMIK CIR
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-4050
Mailing Address - Country:US
Mailing Address - Phone:320-630-9262
Mailing Address - Fax:
Practice Address - Street 1:6939 PINE ARBOR DR S STE 100
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4643
Practice Address - Country:US
Practice Address - Phone:320-630-9262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33221104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker