Individual provider Active NPI

Heather Sardella, MS, LMFT, LPCC

  • Marriage & Family Therapist
  • Glendale, CA
National Provider Identifier
1417224916
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T2672 Issued in OR
Practice address
1540 E Colorado St
Glendale, CA 91205-1514
Phone
(818) 244-7257
NPI assigned
Nov 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 48559 CA
Marriage & Family Therapist 106H00000X T2672 OR Primary

Addresses

Primary practice location

1540 E Colorado St
Glendale, CA 91205-1514

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (818) 638-5492

Other practice location 1

380 9th St
Florence, OR 97439-9470
Phone (541) 997-7134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20250304003746 OR Practitioner - Mental Health Counselor 0143741363 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFC 48559CAMDMarriage & Family Therapist
T2672ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Dec 23, 2024 Accepting new patients
Peacehealth Current Accepting new patients

Locations

390 9th St
Florence, OR 97439
Phone (541) 997-7134

380 9th St
Florence, OR 97439
Phone (541) 997-7134

400 9th St
Florence, OR 97439
Phone (541) 997-8412

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1417224916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "818-638-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051514",
            "telephone_number": "818-244-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 9th St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974399470",
            "country_code": "US",
            "telephone_number": "541-997-7134",
            "fax_number": "541-902-7530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARDELLA",
        "first_name": "HEATHER",
        "credential": "MS, LMFT, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 48559",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T2672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.