Individual provider Active NPI

Sarah Lindsey Heitz, LCSW, PPSC

  • Clinical Social Worker
  • Ontario, CA
National Provider Identifier
1316316920
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW99981 Issued in CA
Practice address
855 N Euclid Ave
Ontario, CA 91762-2729
Phone
(909) 983-2020
NPI assigned
Sep 24, 2015
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ACSW77941 CA
Clinical Social Worker 1041C0700X LCSW99981 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X E1906340 CA

Addresses

Primary practice location

855 N Euclid Ave
Ontario, CA 91762-2729

Mailing address

855 N Euclid Ave
Ontario, CA 91762-2729
Phone (909) 983-2020

Other practice location 1

2008 N Garey Ave
Pomona, CA 91767-2722
Phone (909) 623-6131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727001959 CA Practitioner - Clinical Social Worker 9931502093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

17059 Main St
Hesperia, CA 92345-6067
Phone (760) 956-4170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACSW77941CAMDMental Health Counselor
LCSW99981CAMDClinical Social Worker
E1906340CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jul 19, 2021 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 19, 2021 Accepting new patients
Tri-City Mental Health Center Past Accepting new patients
Tri-City Mental Health Authority PastSince Oct 22, 2019 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

17059 Main St
Hesperia, CA 92345
Phone (760) 956-4170

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1316316920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2008 N Garey Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672722",
            "country_code": "US",
            "telephone_number": "909-623-6131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEITZ",
        "first_name": "SARAH",
        "middle_name": "LINDSEY",
        "credential": "LCSW, PPSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW77941",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW99981",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "E1906340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.