Individual
LAURA N HEESACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 535-6239
Mailing address
1656 ROSS LN, ASHLAND, OR 97520-3429
(541) 631-1128
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4110
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227698
—
OR
05
—
500795190
—
OR
Enumeration date
11/14/2005
Last updated
01/06/2026
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