Provider Demographics
NPI:1962706507
Name:HEAPS, ANNA M (LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:HEAPS
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 1:1850 LARAMIE DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86404-4802
Mailing Address - Country:US
Mailing Address - Phone:775-777-5868
Mailing Address - Fax:
Practice Address - Street 1:1850 LARAMIE DR UNIT B
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86404-4802
Practice Address - Country:US
Practice Address - Phone:775-777-5868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5135560-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical