Basic Information
| Provider Information | |||||||||
| NPI: | 1053629923 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REIMER | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 931 COUNTY ROAD 95 | ||||||||
| Address2: | |||||||||
| City: | NORTH BRANCH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 127665034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454825535 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20 COMMUNITY LN | ||||||||
| Address2: | |||||||||
| City: | LIBERTY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 127542851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452928770 | ||||||||
| FaxNumber: | 8455132110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2010 | ||||||||
| LastUpdateDate: | 10/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 081657-1 | NY | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | NY-083819-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.