MEDICARE: MRS. HEIDI ANNE WHITNEY LCSW, IMHE (III)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1579	CO

General Provider Information

NPI Number	:	1215180385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEIDI ANNE WHITNEY LCSW, IMHE (III)

Provider Business Mailing Address
First Line	:	3401 EUDORA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3066
Country	:	US
Telephone Number	:	303-883-4185
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 EUDORA STREET
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3066
Country	:	US
Telephone Number	:	303-883-4185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2008
Last Update Date	:	12/30/2015

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