Provider Demographics
NPI:1972701829
Name:ROLLAND, HEATHER JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JEAN
Last Name:ROLLAND
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 1:10 N NELLIE HILL RD
Mailing Address - Street 2:
Mailing Address - City:DOVER PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12522-5404
Mailing Address - Country:US
Mailing Address - Phone:845-877-1241
Mailing Address - Fax:
Practice Address - Street 1:10 N NELLIE HILL RD
Practice Address - Street 2:
Practice Address - City:DOVER PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12522-5404
Practice Address - Country:US
Practice Address - Phone:845-877-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0755621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical