Healthcare Provider Details

I. General information

NPI: 1801234125
Provider Name (Legal Business Name): SARAH HOAGUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2013
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 HIGHLAND AVE NSCH
SALEM MA
01970-2141
US

IV. Provider business mailing address

540 VFW PKWY STE 6
WEST ROXBURY MA
02132-1332
US

V. Phone/Fax

Practice location:
  • Phone: 978-354-2700
  • Fax: 978-740-4902
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: