Provider Demographics
NPI:1982606901
Name:HEYNEN, ARLENE T (MSW LISW)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:T
Last Name:HEYNEN
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 S SYCAMORE AVE STE 105-3
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-1255
Mailing Address - Country:US
Mailing Address - Phone:605-334-3739
Mailing Address - Fax:605-334-7752
Practice Address - Street 1:400 CENTRAL AVE NW STE 300
Practice Address - Street 2:SUITE 103
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1332
Practice Address - Country:US
Practice Address - Phone:712-737-2635
Practice Address - Fax:712-737-2344
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALISW #02586104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA363864095Medicaid
IAI2204Medicare PIN