Provider Demographics
NPI:1316069784
Name:HEIL, CAROL J (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:HEIL
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8811 COLESVILLE RD
Mailing Address - Street 2:SUITE #106
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4343
Mailing Address - Country:US
Mailing Address - Phone:301-899-4841
Mailing Address - Fax:301-585-7426
Practice Address - Street 1:8811 COLESVILLE RD
Practice Address - Street 2:SUITE #106
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4343
Practice Address - Country:US
Practice Address - Phone:301-899-4841
Practice Address - Fax:301-585-7426
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD48701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD641447Medicare ID - Type Unspecified