Healthcare Provider Details

I. General information

NPI: 1619977501
Provider Name (Legal Business Name): SARAH ELISABETH HERBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 PONCE DE LEON AVE NE
ATLANTA GA
30308-2012
US

IV. Provider business mailing address

720 WESTVIEW DR SW
ATLANTA GA
30310-1458
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-2440
  • Fax: 404-616-9732
Mailing address:
  • Phone: 404-756-1400
  • Fax: 404-756-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number030092
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number030092
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: