Provider Demographics
NPI:1609361658
Name:HEIDEL, SARAH MARGARET (PSYD, LCP)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARGARET
Last Name:HEIDEL
Suffix:
Gender:F
Credentials:PSYD, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 29TH BAY ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-2026
Mailing Address - Country:US
Mailing Address - Phone:757-358-2498
Mailing Address - Fax:
Practice Address - Street 1:9485 29TH BAY ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-2026
Practice Address - Country:US
Practice Address - Phone:757-358-2498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006005103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical