Provider Demographics
NPI:1538973177
Name:MOUSEL, HEATHER (MSW, CSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MOUSEL
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 S MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4877
Mailing Address - Country:US
Mailing Address - Phone:605-334-1822
Mailing Address - Fax:605-334-1808
Practice Address - Street 1:622 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4877
Practice Address - Country:US
Practice Address - Phone:605-334-1822
Practice Address - Fax:605-334-1808
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
SD6760104100000X
SD1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker