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General NPI Number Information
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NPI Number | 1447959820
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Entity Type | Individual
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Provider Name | HEIDI LYN WORKMAN LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 1324 LAKE DR SE STE 1
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-1673
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Country | US
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Telephone | 908-788-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 4520 BRIDLEWOOD DR
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City | HUDSONVILLE
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State | MI
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Zip | 49426-7442
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Country | US
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Telephone | 616-570-7056
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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 | 6801090494
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License Number State | MI
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