Healthcare Provider Details

I. General information

NPI: 1083063051
Provider Name (Legal Business Name): SARAH HAASE LPC, LPCC, CCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19712 MACARTHUR BLVD STE 110
IRVINE CA
92612-2407
US

IV. Provider business mailing address

1968 S COAST HWY STE 1293
LAGUNA BEACH CA
92651-3681
US

V. Phone/Fax

Practice location:
  • Phone: 657-205-6154
  • Fax:
Mailing address:
  • Phone: 657-205-6154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9835
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number008246
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: