Healthcare Provider Details

I. General information

NPI: 1013441609
Provider Name (Legal Business Name): HEATHER ROSE HEIGERT LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER ROSE ZARGER

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 WESTPORT DR # D2
MANHATTAN KS
66502-2880
US

IV. Provider business mailing address

1329 18TH ST
BELLEVILLE KS
66935-2209
US

V. Phone/Fax

Practice location:
  • Phone: 785-560-3101
  • Fax: 785-527-8317
Mailing address:
  • Phone: 785-560-3101
  • Fax: 785-527-8317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4781
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier201167370C
Identifier TypeMEDICAID
Identifier StateKS
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: