Provider Demographics
NPI:1336928100
Name:HEINICKE, MARGARET MORRISSEY
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:MORRISSEY
Last Name:HEINICKE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SANTA RITA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1465
Mailing Address - Country:US
Mailing Address - Phone:415-342-9463
Mailing Address - Fax:
Practice Address - Street 1:2485 CLAY ST STE 104
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1874
Practice Address - Country:US
Practice Address - Phone:212-227-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT1525211041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program