Provider Demographics
NPI:1710392006
Name:AFRIECQ, SARAH (PSYD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:AFRIECQ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEARTS AND MINDS PSYCHOLOGICAL SERVICES
Mailing Address - Street 2:207 CHRISTOPHER DR.
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5349
Mailing Address - Country:US
Mailing Address - Phone:570-677-7687
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DR.
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:270-798-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY591103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710392006OtherMILITARY