Provider Demographics
NPI:1972790509
Name:HEFFERNAN, STEVE C (LMSW)
Entity type:Individual
Prefix:MR
First Name:STEVE
Middle Name:C
Last Name:HEFFERNAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MACK RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2714
Mailing Address - Country:US
Mailing Address - Phone:845-452-2372
Mailing Address - Fax:
Practice Address - Street 1:46 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4518
Practice Address - Country:US
Practice Address - Phone:845-452-2372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069939104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker