Provider Demographics
NPI:1144827551
Name:HARTZ, HEIDI ELIZABETH (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:ELIZABETH
Last Name:HARTZ
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14317 RUNABOUT CT APT 11
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6161
Mailing Address - Country:US
Mailing Address - Phone:406-544-2799
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE JOINT BASE LEWIS-MCCHORD
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD218591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical