Provider Demographics
NPI:1194366575
Name:BOXRUD, HEATHER LEE (LMSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEE
Last Name:BOXRUD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 13TH ST S
Mailing Address - Street 2:
Mailing Address - City:HETTINGER
Mailing Address - State:ND
Mailing Address - Zip Code:58639-7526
Mailing Address - Country:US
Mailing Address - Phone:701-928-0594
Mailing Address - Fax:
Practice Address - Street 1:1463 I94 BUSINESS LOOP E
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-6434
Practice Address - Country:US
Practice Address - Phone:701-227-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ND6618104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator