| Provider / Organization | NPI | Date Certified |
|---|---|---|
| HEIDI A ISON | 1558687665 | 2023-08-13 |
Heidi A Ison is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1558687665. Registration indicates Heidi A Ison is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Social Worker (Behavioral Health & Social Service Providers, Social Worker) (Social Worker: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker Clinical, Behavioral Health & Social Service Providers) (Social Worker, ) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Social Worker) (Behavioral Health & Social Service Providers, Social Worker) (Social Worker: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker Clinical, Behavioral Health & Social Service Providers) (Social Worker, )
| Entity Type | Individual |
| Provider Name | Ms. Heidi A Ison LCSW |
| Other Provider Name | Mrs. Heidi A Petracco |
| Practice Office Address | 2005 PAN AM CIR STE 120 TAMPA, FL US |
| Practice Office Telephone | 8136022312 |
| Mailing Address | 2005 PAN AM CIR STE 120 TAMPA, FL 336072529 US |
| Business Telephone | 8136022312 |
| Business Fax | 8133021173 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 5121 Ehrlich Rd Bldg 101, Suite G | Tampa, FL 336242049 | 9737225880 |
| 6938 W Linebaugh Ave Ste 101 | Tampa, FL 336255824 | 8136022312 / 8132650586 |
| Code | Practice | License No State |
|---|---|---|
| 1041C0700X | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker: Clinical Behavioral Health/Substance Abuse/Psychiatry Social Worker Clinical Behavioral Health & Social Service Providers Social Worker | 9771
FL |
| 1041C0700X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker: Clinical Behavioral Health/Substance Abuse/Psychiatry Social Worker Clinical Behavioral Health & Social Service Providers Social Worker | SW9771
FL |
| 2244600 | MEDICAID | FL |