Provider Demographics
NPI:1114454022
Name:HEATON, SARA E
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:HEATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421
Mailing Address - Country:US
Mailing Address - Phone:339-223-0432
Mailing Address - Fax:
Practice Address - Street 1:80 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7430
Practice Address - Country:US
Practice Address - Phone:339-223-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical