Healthcare Provider Details

I. General information

NPI: 1538623103
Provider Name (Legal Business Name): SARAH K HIEBERT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BEECHCROFT ST
BRIGHTON MA
02135-2519
US

IV. Provider business mailing address

50 BEECHCROFT ST
BRIGHTON MA
02135-2519
US

V. Phone/Fax

Practice location:
  • Phone: 617-635-7945
  • Fax: 617-635-7949
Mailing address:
  • Phone: 617-635-7945
  • Fax: 617-635-7949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number22184
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: