Provider Demographics
NPI:1568706471
Name:KONSOL, HIEDI L (LISW-S; LCSW)
Entity type:Individual
Prefix:MS
First Name:HIEDI
Middle Name:L
Last Name:KONSOL
Suffix:
Gender:F
Credentials:LISW-S; LCSW
Other - Prefix:MS
Other - First Name:HIEDI
Other - Middle Name:L
Other - Last Name:GODFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:1909 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-3919
Mailing Address - Country:US
Mailing Address - Phone:330-953-9305
Mailing Address - Fax:
Practice Address - Street 1:13420 N MERIDIAN ST STE 400
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1581
Practice Address - Country:US
Practice Address - Phone:317-573-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0700053SUPV1041C0700X
IN34011204A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical