Provider Demographics
NPI:1871807966
Name:HEUERMANN, TESSA LEE (MSW)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:LEE
Last Name:HEUERMANN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:LEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3205 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-4551
Mailing Address - Country:US
Mailing Address - Phone:406-529-2254
Mailing Address - Fax:
Practice Address - Street 1:3205 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4551
Practice Address - Country:US
Practice Address - Phone:406-529-2254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
WYPCSW-417104100000X, 1041C0700X
MTBBH-LCSW-LIC-701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker