Provider Demographics
NPI:1104183532
Name:HEISLER, DAVID ROBERT (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ROBERT
Last Name:HEISLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W 51ST ST
Mailing Address - Street 2:304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6515
Mailing Address - Country:US
Mailing Address - Phone:202-210-0005
Mailing Address - Fax:
Practice Address - Street 1:410 W 51ST ST
Practice Address - Street 2:304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6515
Practice Address - Country:US
Practice Address - Phone:202-210-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0709821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical