Provider Demographics
NPI:1427843200
Name:SUYDAM, HEIDI
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:SUYDAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 WALDEN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1787
Mailing Address - Country:US
Mailing Address - Phone:813-727-5513
Mailing Address - Fax:
Practice Address - Street 1:610 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-3512
Practice Address - Country:US
Practice Address - Phone:615-823-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health