Provider Demographics
NPI:1174990782
Name:ARMIJO, HEATHER MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PETER COOPER RD APT MH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6736
Mailing Address - Country:US
Mailing Address - Phone:585-409-8361
Mailing Address - Fax:
Practice Address - Street 1:4 PETER COOPER RD APT MH
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6736
Practice Address - Country:US
Practice Address - Phone:585-409-8361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1012191104100000X
NJ44SC060630001041C0700X
NY090817-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker