Healthcare Provider Details

I. General information

NPI: 1053629923
Provider Name (Legal Business Name): HEIDI JANE REIMER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COMMUNITY LN
LIBERTY NY
12754-2851
US

IV. Provider business mailing address

931 COUNTY ROAD 95
NORTH BRANCH NY
12766-5034
US

V. Phone/Fax

Practice location:
  • Phone: 845-292-8770
  • Fax: 845-513-2110
Mailing address:
  • Phone: 845-482-5535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number081657-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberNY-083819-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: