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General NPI Number Information
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NPI Number | 1952812752
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Entity Type | Individual
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Provider Name | HEIDI DAWN PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1331 ELMWOOD AVE STE 300B
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City | COLUMBIA
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State | SC
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Zip | 29201-2150
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Country | US
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Telephone | 803-200-2601
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Fax | 803-961-6600
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Provider Business Mailing Address
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Address Line | PO BOX 2512
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City | IRMO
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State | SC
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Zip | 29063-4000
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Country | US
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Telephone | 803-200-2601
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Fax | 803-961-6600
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5430
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1528
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 17115
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 17115
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License Number State | CA
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