Basic Information
| Provider Information | |||||||||
| NPI: | 1295960573 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THORPE | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW-R | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | REDMOND | ||||||||
| OtherFirstName: | HEATHER | ||||||||
| OtherMiddleName: | D | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MSW, LCSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 223 HARVARD RD | ||||||||
| Address2: | |||||||||
| City: | PORT MATILDA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168707307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082174152 | ||||||||
| FaxNumber: | 8143170341 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 NEW KARNER RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122053854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184311650 | ||||||||
| FaxNumber: | 5184262835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2009 | ||||||||
| LastUpdateDate: | 02/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW016273 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.