| Heidi Conner Licsw Llc | |
|
46 Forge Rd Kingston MA 02364-1091 | |
| (781) 582-1187 | |
| (781) 527-4073 |
| Full Name | Heidi Conner Licsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 46 Forge Rd, Kingston, Massachusetts |
| Authorized Official Name and Position | Heidi Tompkins Conner (OWNER) |
| Authorized Official Contact | 7812648325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heidi Conner Licsw Llc 46 Forge Rd Kingston MA 02364-1091 Ph: (781) 582-1187 | Heidi Conner Licsw Llc 46 Forge Rd Kingston MA 02364-1091 Ph: (781) 582-1187 |
| NPI Number | 1861171902 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/16/2023 |
| Medicare PECOS PAC ID | 3274994850 |
|---|---|
| Medicare Enrollment ID | O20230728002043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861171902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Heidi Tompkins Conner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013492586 PECOS PAC ID: 3779942883 Enrollment ID: I20230728002012 |
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