Heidi Lee Lively is a Clinical in Woodbridge, Connecticut. Heidi Lee Lively practices all healthcare services and medical treatments related to Clinical. The NPI Number for Heidi Lee Lively is 1174694202. The last update date is 2023-10-31.
Heidi Lee Lively's current location address is 15 Osborne Ln, Woodbridge, Connecticut. You can contact this provider via phone number 2075223676. The mailing address for Heidi Lee Lively is 15 Osborne Ln, Woodbridge, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Heidi Lee Lively |
|---|---|
| Address | 15 Osborne Ln, Woodbridge, Connecticut |
| Phone Number | 2075223676 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | L.C.S.W. |
NPI Number Detail
| NPI Number | 1174694202 |
|---|---|
| Provider Enumeration Date | 2006-11-12 |
| Last Updated Date | 2023-10-31 |
Provider Mailing Address Detail
| Address | 15 Osborne Ln |
|---|---|
| City | Woodbridge |
| State | Connecticut (CT) |
| Post Code | 65251728 |
| Phone Number | 2075223676 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 9440 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identification code assigned to Heidi Lee Lively by the Centers for Medicare & Medicaid Services?
The Heidi Lee Lively has been issued the NPI (National Provider Identifier) 1174694202, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Heidi Lee Lively?
The Heidi Lee Lively is situated at 15 Osborne Ln, in the city of Woodbridge, state of CT, with the zip code 65251728.
What is the Heidi Lee Lively's specialty and taxonomy code?
The Heidi Lee Lively's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
When was the Heidi Lee Lively's 1174694202 issued?
The Heidi Lee Lively's 1174694202 was issued on 2006-11-12.
As of what date were the Heidi Lee Lively's details last updated?
The information pertaining to the Heidi Lee Lively, including its address, specialty, and other details, was most recently updated on 2023-10-31.