Provider Demographics
NPI:1710736111
Name:MELVER, HEATHER LIV (MSW, LSWAIC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LIV
Last Name:MELVER
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4471 E PICKERING RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-7029
Mailing Address - Country:US
Mailing Address - Phone:360-499-5735
Mailing Address - Fax:
Practice Address - Street 1:4471 E PICKERING RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-7029
Practice Address - Country:US
Practice Address - Phone:360-499-5735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC615443311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical