Crockett, Heidi

Crockett, Heidi is an sole proprietor health care provider with primary practice located at 1432 Dr Martin Luther King Jr St N , Saint Petersburg FL 33704-3302. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Crockett, Heidi can be contacted via phone (727) 288-4117.

Contact Information

Primary practice address
1432 Dr Martin Luther King Jr St N Saint Petersburg FL 33704-3302
Phone: (727) 288-4117
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X MA42442 Florida
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW12581 Florida

Profile Details

NPI number 1255521951
LBN Legal business name Crockett, Heidi
Credentials LCSW, LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2007
Last updated Mar 19th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255521951 NPPES
Florida Other C2933 BLUE CROSS BLUE SHIELD PR

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