Provider Demographics
NPI:1962130757
Name:SIGMUND, HEATHER RAY
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:RAY
Last Name:SIGMUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5908 WHITEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4390
Mailing Address - Country:US
Mailing Address - Phone:706-570-7920
Mailing Address - Fax:
Practice Address - Street 1:214 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2745
Practice Address - Country:US
Practice Address - Phone:706-225-9598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2024-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPCLPC015285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional