Healthcare Provider Details

I. General information

NPI: 1538605001
Provider Name (Legal Business Name): ANGELA HECK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 03/06/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 SIJEN AVE
WHITEMAN AIR FORCE BASE MO
65305-1269
US

IV. Provider business mailing address

101 GRAY LN BUILDING 3007
WHITEMAN AIR FORCE BASE MO
65305
US

V. Phone/Fax

Practice location:
  • Phone: 660-687-4341
  • Fax:
Mailing address:
  • Phone: 660-687-4341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2019016718
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2016001990
License Number StateMO

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: