Heather B Mandeville, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124058 Issued in MA

Practice address

135 Gold Star Blvd
Worcester, MA 01606-2738

Phone

(508) 459-6400

Fax

(508) 849-5618

NPI assigned

Oct 23, 2017

Last updated

Jul 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Heather B Flynn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1487165072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062738",
            "telephone_number": "508-459-6400",
            "fax_number": "508-849-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062738",
            "telephone_number": "508-459-6400",
            "fax_number": "508-849-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "HEATHER",
        "middle_name": "B",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LCSW224417",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LICSW124058",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "FLYNN",
            "middle_name": "B",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Divakar Mandapati, M.D.
• Zachary Tyler Mandel
• Daniel T. Mandell, M.D.
• Elizabeth Ellis Mandell, LICSW
• Adam Mandeville
• Lucia E Maneri, LMHC
• Jessica Marie Manger, LICSW
• Christy Mangiacotti, NP
• Jessica Lynne Mangiameli, LCSW
• Johnmark Mangiameli, M.S.W

• Clinical Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.