MEDICARE: DR. SARAH MARGARET HEIDEL PSY.D., LCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810006005	VA

General Provider Information

NPI Number	:	1609361658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH MARGARET HEIDEL PSY.D., LCP

Provider Business Mailing Address
First Line	:	9485 29TH BAY ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-2026
Country	:	US
Telephone Number	:	757-358-2498
Fax Number	:

Provider Business Practice Location Address
First Line	:	9485 29TH BAY ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-2026
Country	:	US
Telephone Number	:	757-358-2498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	03/11/2021

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