Healthcare Provider Details

I. General information

NPI: 1689724122
Provider Name (Legal Business Name): SARAH HEBERT LPC, LADAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 CANDLEWOOD DR
SOUTH WINDSOR CT
06074-2610
US

IV. Provider business mailing address

41 CANDLEWOOD DR
SOUTH WINDSOR CT
06074-2610
US

V. Phone/Fax

Practice location:
  • Phone: 860-930-7287
  • Fax:
Mailing address:
  • Phone: 860-930-7287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000754
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001576
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: