Provider Demographics
NPI:1730564345
Name:AUST-COX, HEIDI K (LISW-S)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:K
Last Name:AUST-COX
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:K
Other - Last Name:AUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:329 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4332
Mailing Address - Country:US
Mailing Address - Phone:419-221-3072
Mailing Address - Fax:
Practice Address - Street 1:1550 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-2823
Practice Address - Country:US
Practice Address - Phone:419-405-7540
Practice Address - Fax:419-225-8878
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1440144-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0174603Medicaid