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Individual

HEATHER DEROSIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSSW

Contact information

Practice address
1626 N LITCHFIELD RD STE 200, GOODYEAR, AZ 85395-1254
(615) 924-9205
Mailing address
4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
(615) 924-9205

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
LMSW-21034
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
330000014
AL
Enumeration date
04/24/2019
Last updated
06/27/2025
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