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NPI Code Detail

MEDICARE: MISS HEIKE A B LAKE M.ED, LSW

MEDICARE: MISS HEIKE A B LAKE M.ED, LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorRC00043068WA
2104100000XSocial WorkerLSW-1799ID

General Provider Information

NPI Number : 1720134992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS HEIKE A B LAKE M.ED, LSW
Provider Business Mailing Address
First Line : 3801 W HIGHWATER DR
Second Line :
City : POST FALLS
State : ID
Zip : 83854-9492
Country : US
Telephone Number : 208-691-3787
Fax Number :
Provider Business Practice Location Address
First Line : 210 W SPRAGUE AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99201-3627
Country : US
Telephone Number : 509-747-8224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2007
Last Update Date : 09/11/2025

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Directions to “ MISS HEIKE A B LAKE M.ED, LSW” Practice Location

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