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General NPI Number Information
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NPI Number | 1588444590
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Entity Type | Individual
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Provider Name | MELISA S HECKATHORN LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 4600 KIETZKE LN STE N250
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City | RENO
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State | NV
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Zip | 89502-5000
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Country | US
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Telephone | 775-500-0396
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Fax | 775-507-7224
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Provider Business Mailing Address
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Address Line | 301 TOLAS PL SPC 18
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City | FALLON
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State | NV
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Zip | 89406-8998
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Country | US
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Telephone | 775-217-0228
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Fax | 775-507-7224
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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 | 11029-M
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License Number State | NV
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