Provider Demographics
NPI:1912288507
Name:KIXMILLER, HEIDI BETH (LCSW)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:BETH
Last Name:KIXMILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-2401
Mailing Address - Country:US
Mailing Address - Phone:080-775-1921
Mailing Address - Fax:
Practice Address - Street 1:29 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2401
Practice Address - Country:US
Practice Address - Phone:080-775-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0074031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical