Healthcare Provider Details

I. General information

NPI: 1538497615
Provider Name (Legal Business Name): HEATHER MHAIRI STEIMLOSK MOTR/L, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E TERRY ST
POCATELLO ID
83209-0001
US

IV. Provider business mailing address

1400 E TERRY
POCATELLO ID
83209-0001
US

V. Phone/Fax

Practice location:
  • Phone: 208-282-3006
  • Fax:
Mailing address:
  • Phone: 208-282-3006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 35130
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT-2561
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: