Healthcare Provider Details

I. General information

NPI: 1649996653
Provider Name (Legal Business Name): SARAH HEFT ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 09/30/2023
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 TYDD ST
EUREKA CA
95501-1284
US

IV. Provider business mailing address

600 F ST. STE 3 PMB 907
ARCATA CA
95521-6301
US

V. Phone/Fax

Practice location:
  • Phone: 707-441-1624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number110913
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110913
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number110913
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number110913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: