Individual ProviderLaura N HeesackerSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1656 Ross Ln, Ashland, OR 97520-3429(541) 631-1128PECOS EnrollmentBased on the most recent information from CMS, provider Laura N Heesacker does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1205818580Provider TypeIndividualFull NameHeesacker, Laura NCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date11/14/2005Last Updated4/18/2024Contact InformationPractice LocationPractice Address1656 Ross Ln, Ashland, OR 97520-3429Phone(541) 631-1128FaxUnlisted FaxMailing LocationMailing Address1656 Ross Ln, Ashland, OR 97520-3429Phone(541) 631-1128FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseL4110OregonProvider IdentifiersIDDescriptionIssuerID500795190DescriptionMedicaidIssuerUnlistedOregonID227698DescriptionMedicaidIssuerUnlistedOregon