Healthcare Provider Details

I. General information

NPI: 1942166475
Provider Name (Legal Business Name): SARAH HAASE THERAPY, LICENSED PROFESSIONAL CLINICAL COUNSELOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
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 # 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 Number
License Number State

VIII. Authorized Official

Name: SARAH JANE HAASE
Title or Position: CEO
Credential: LPCC
Phone: 657-205-6154