Provider Demographics
NPI:1972590461
Name:HEARD, SARAH B (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:HEARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 BUFORD RD
Mailing Address - Street 2:
Mailing Address - City:N. CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4017
Mailing Address - Country:US
Mailing Address - Phone:804-852-0224
Mailing Address - Fax:
Practice Address - Street 1:2520 BUFORD RD
Practice Address - Street 2:
Practice Address - City:N. CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4017
Practice Address - Country:US
Practice Address - Phone:804-852-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040029321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010176131Medicaid
VA007049I22Medicare ID - Type Unspecified