Healthcare Provider Details

I. General information

NPI: 1598038903
Provider Name (Legal Business Name): DEANNA HEATH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 12/13/2020
Certification Date: 12/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 COURT ST STE B
MT PLEASANT MI
48858-2358
US

IV. Provider business mailing address

210 COURT ST STE B
MT PLEASANT MI
48858-2358
US

V. Phone/Fax

Practice location:
  • Phone: 989-572-0246
  • Fax: 898-174-4429
Mailing address:
  • Phone: 989-560-5551
  • Fax: 989-817-4442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801093193
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: