Provider Demographics
NPI:1871996660
Name:SHEVCHUK, SARAH B (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:B
Last Name:SHEVCHUK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 ENTERPRISE DR STE B
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-5697
Mailing Address - Country:US
Mailing Address - Phone:292-930-1322
Mailing Address - Fax:
Practice Address - Street 1:348 ENTERPRISE DR STE B
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-5697
Practice Address - Country:US
Practice Address - Phone:292-930-1322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical