Individual provider Active NPI

Heather Ann Comeau, LMSW

  • Social Worker
  • Stockton, CA
National Provider Identifier
1205407160
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1564P-S Issued in NV
Practice address
2495 W March LN Ste 125
Stockton, CA 95207-8224
Phone
(702) 622-2491
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1564P-S NV Primary

Addresses

Primary practice location

2495 W March LN Ste 125
Stockton, CA 95207-8224

Mailing address

4650 Balsam St
Las Vegas, NV 89108-5706
Phone (702) 477-5811

Other names 1

  • Heather Ann Ehinger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1564P-SNVMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1205407160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 BALSAM ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891085706",
            "telephone_number": "702-477-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 W MARCH LN STE 125",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078224",
            "telephone_number": "702-622-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMEAU",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "1564P-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "EHINGER",
            "middle_name": "ANN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.