Provider Demographics
NPI:1134722374
Name:HEROLD, SCHEYDEN WYATT (LMFT)
Entity type:Individual
Prefix:
First Name:SCHEYDEN
Middle Name:WYATT
Last Name:HEROLD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16742 LYNN LN APT D
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3969
Mailing Address - Country:US
Mailing Address - Phone:657-845-1018
Mailing Address - Fax:
Practice Address - Street 1:5762 BOLSA AVE STE 107
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1172
Practice Address - Country:US
Practice Address - Phone:657-845-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122478101YM0800X
CA137593101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health