Provider Demographics
NPI:1700551108
Name:JENNINGS, HEATHER (LMSW, CSWI)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LMSW, CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SHADY LANE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5427
Mailing Address - Country:US
Mailing Address - Phone:775-741-7420
Mailing Address - Fax:
Practice Address - Street 1:5540 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2599
Practice Address - Country:US
Practice Address - Phone:775-448-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IC-22741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical