Provider Demographics
NPI:1023656584
Name:BEHRENDT, HEIDI (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:BEHRENDT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1796 MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:NH
Mailing Address - Zip Code:03574-4743
Mailing Address - Country:US
Mailing Address - Phone:802-673-5971
Mailing Address - Fax:
Practice Address - Street 1:461 MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:NH
Practice Address - Zip Code:03580-4836
Practice Address - Country:US
Practice Address - Phone:026-735-9718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01342431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical