Provider Demographics
NPI:1548453517
Name:LINDH-PAYNE, HEATHER (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LINDH-PAYNE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 DEERFERN CRES
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4606
Mailing Address - Country:US
Mailing Address - Phone:301-481-0823
Mailing Address - Fax:
Practice Address - Street 1:6302 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2003
Practice Address - Country:US
Practice Address - Phone:443-834-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.010982104100000X
IL149.0131771041C0700X
MD151791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker