Provider Demographics
NPI:1427303650
Name:YOCUM, HEATHER NICOLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:YOCUM
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 1:925 W SKYLINE RD APT 921
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-4041
Mailing Address - Country:US
Mailing Address - Phone:620-441-7619
Mailing Address - Fax:
Practice Address - Street 1:22214 D ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-7376
Practice Address - Country:US
Practice Address - Phone:620-442-4540
Practice Address - Fax:620-442-4559
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW 8517104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker