Provider Demographics
NPI:1326399049
Name:SEWALL, HEATHER DIANE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:DIANE
Last Name:SEWALL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-534-1189
Mailing Address - Fax:
Practice Address - Street 1:9023 RANDALL RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2923
Practice Address - Country:US
Practice Address - Phone:256-507-9545
Practice Address - Fax:256-857-1195
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional