Provider Demographics
NPI:1386411411
Name:SPIVEY, HEATHER N (MSW, LCSW, CSAC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:N
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:MSW, LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 S SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5039
Mailing Address - Country:US
Mailing Address - Phone:804-835-6100
Mailing Address - Fax:804-722-9529
Practice Address - Street 1:541 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-5039
Practice Address - Country:US
Practice Address - Phone:804-835-6100
Practice Address - Fax:804-722-9529
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040160561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical