Provider Demographics
NPI:1366590606
Name:REICHHOLD, HEIDI B (LICSW)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:B
Last Name:REICHHOLD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:REICHHOLD-CARUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:227 WOOD ST
Mailing Address - Street 2:APT. D
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1013
Mailing Address - Country:US
Mailing Address - Phone:781-424-4487
Mailing Address - Fax:
Practice Address - Street 1:206 MILFORD ST
Practice Address - Street 2:
Practice Address - City:UPTON
Practice Address - State:MA
Practice Address - Zip Code:01568-1309
Practice Address - Country:US
Practice Address - Phone:508-529-7000
Practice Address - Fax:508-529-7024
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2120741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical