Healthcare Provider Details

I. General information

NPI: 1013729276
Provider Name (Legal Business Name): AISLING HEGARTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HILLIARD ST
CAMBRIDGE MA
02138-4972
US

IV. Provider business mailing address

337 COLUMBIA ST
CAMBRIDGE MA
02141-1309
US

V. Phone/Fax

Practice location:
  • Phone: 978-831-2695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002626
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002626
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: