Provider Demographics
NPI:1336486737
Name:HELLER, SARAH ELISABETH (MSED)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELISABETH
Last Name:HELLER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELISABETH
Other - Last Name:KNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:35 HILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1310
Mailing Address - Country:US
Mailing Address - Phone:718-598-1897
Mailing Address - Fax:
Practice Address - Street 1:35 HILLWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1310
Practice Address - Country:US
Practice Address - Phone:718-598-1897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-14-9658103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst