Provider Demographics
NPI:1609252865
Name:HVIZDAK, SARA LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LYNN
Last Name:HVIZDAK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:HVIZDAK
Other - Last Name:PENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:WHALESONG COUNSELING
Mailing Address - Street 2:1330 SE 9TH ST SUITE 2
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-2618
Mailing Address - Country:US
Mailing Address - Phone:541-614-0294
Mailing Address - Fax:971-200-2720
Practice Address - Street 1:WHALESONG COUNSELING
Practice Address - Street 2:1330 SE 9TH ST SUITE 2
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-2618
Practice Address - Country:US
Practice Address - Phone:541-614-0294
Practice Address - Fax:971-200-2720
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC6948101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health