Healthcare Provider Details

I. General information

NPI: 1114415395
Provider Name (Legal Business Name): KATHERINE TERESA HEGARTY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KERRY TERESA HEGARTY LPC

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 GENERAL TAYLOR ST
NEW ORLEANS LA
70125-2915
US

IV. Provider business mailing address

3725 S GALVEZ ST
NEW ORLEANS LA
70125-3724
US

V. Phone/Fax

Practice location:
  • Phone: 504-608-2023
  • Fax:
Mailing address:
  • Phone: 504-608-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6077
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: