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General NPI Number Information
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NPI Number | 1215034269
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Entity Type | Individual
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Provider Name | LEE ELLEN HECKERMAN LSCSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1900 E. WASHINGTON
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City | FREDONIA
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State | KS
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Zip | 66063
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Country | US
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Telephone | 620-378-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 4909 SCOTT RD
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City | NEODESHA
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State | KS
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Zip | 66757-1694
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Country | US
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Telephone | 316-619-1101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1953
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License Number State | KS
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